{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:07:51Z","timestamp":1790251671334,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Int Soc Prev Community Dent"],"published-print":{"date-parts":[[2025,7]]},"abstract":"\n A\n bstract<\/jats:sc>\n <\/jats:title>\n \n Aim:<\/jats:title>\n Dental treatment-related pain causes fear and anxiety, particularly in children. Minimally invasive dentistry techniques, such as chemo-mechanical caries removal (CMCR) and atraumatic restorative treatment (ART), aim to minimize discomfort. This study evaluated and compared pain perception during caries removal using a CMCR agent (BRIX 3000) versus ART in children aged 4\u20138 years.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n A randomized, two-arm clinical trial was conducted with 40 children aged 4\u20138, each with at least two carious lesions on primary molars. Children were randomly assigned to caries removal using either BRIX 3000 (CMCR) or ART. Pain was assessed using the sound, eye, and motor (SEM) scale and the Wong-Baker FACES scale. Data were analyzed statistically.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In the CMCR group, 67.5% of children had an SEM pain score of 0, while 70% had an SEM score of 0 in the ART group. The mean SEM pain scores were 0.43 \u00b1 0.71 for CMCR and 0.40 \u00b1 0.71 for ART. The mean Wong-Baker FACES pain scores were 0.45 \u00b1 0.96 for CMCR and 0.60 \u00b1 1.30 for ART. There was no statistically significant difference as the\n P<\/jats:italic>\n -value was not less than 0.05 for pain scores between the two groups using either SEM (\n P<\/jats:italic>\n -value = 0.785) or Wong-Baker FACES (\n P<\/jats:italic>\n -value = 0.412) scales.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Both CMCR with BRIX 3000\n \u2122<\/jats:sup>\n and ART were effective in minimizing pain during caries removal in young children. However, the difference in pain scores between the two groups was not statistically significant, as indicated by a\n P<\/jats:italic>\n -value greater than 0.05 for both the SEM scale (\n P<\/jats:italic>\n = 0.785) and the Wong-Baker FACES scale (\n P<\/jats:italic>\n = 0.412).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jispcd.jispcd_219_24","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T19:02:16Z","timestamp":1754074936000},"page":"348-356","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Pain Perception During Minimally Invasive Caries Removal in Children: A Randomized Clinical Trial Comparing Chemo-Mechanical Caries Removal"],"prefix":"10.4103","volume":"15","author":[{"given":"Dhirja","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Awasthi","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanina","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhdeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nenung","family":"Yirang","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"CIT0001-20250902","first-page":"187","article-title":"Success and behavior during atraumatic restorative treatment, the hall technique, and the stainless steel crown technique for primary molar teeth","volume":"42","author":"Ebrahimi","year":"2020","journal-title":"Pediatr Dent"},{"key":"CIT0002-20250902","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.5395\/rde.2023.48.e19","article-title":"The clinical success of ART restorations and Hall technique in primary molars: A randomized 18-month follow-up study","volume":"48","author":"Oz","year":"2023","journal-title":"Restor Dent Endod"},{"key":"CIT0003-20250902","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24018\/ejdent.2024.5.3.334","article-title":"Atraumatic restorative treatment: An overview and update","volume":"5","author":"Hodali","year":"2024","journal-title":"EJDENT"},{"key":"CIT0004-20250902","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12903-020-01298-x","article-title":"Atraumatic restorative treatment compared to the Hall technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting","volume":"20","author":"Araujo","year":"2020","journal-title":"BMC Oral Health"},{"key":"CIT0005-20250902","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.sdentj.2023.01.010","article-title":"Chemomechanical caries removal methods: A literature review","volume":"35","author":"Maashi","year":"2023","journal-title":"Saudi Dent J"},{"key":"CIT0006-20250902","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.3390\/biomedicines12081735","article-title":"Antimicrobial efficacy of chemomechanical carie removal agents\u2014A systematic integrative review","volume":"12","author":"Janvier","year":"2024","journal-title":"Biomedicines"},{"key":"CIT0007-20250902","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4103\/JCD.JCD_269_20","article-title":"Comparative evaluation of BRIX3000, CARIE CARE, and SMART BURS in caries excavation: An in vivo study","volume":"23","author":"Inamdar","year":"2020","journal-title":"J Conserv Dent"},{"key":"CIT0008-20250902","doi-asserted-by":"crossref","first-page":"11","DOI":"10.21608\/adjc.2021.103368.1119","article-title":"Chemomechanical caries removal agents and their applications in pediatric dentistry","volume":"4","author":"Abdelaziz","year":"2022","journal-title":"Advanc Dent J"},{"key":"CIT0009-20250902","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1038\/sj.bdj.2017.664","article-title":"Atraumatic restorative treatment and minimal intervention dentistry","volume":"223","author":"Frencken","year":"2017","journal-title":"Br Dent 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cooperation: A randomized controlled clinical trial","volume":"93","author":"Muaaz","year":"2020","journal-title":"J Dent"},{"key":"CIT0013-20250902","doi-asserted-by":"crossref","first-page":"e0208437","DOI":"10.1371\/journal.pone.0208437","article-title":"Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis","volume":"13","author":"Ladewig","year":"2018","journal-title":"PLoS One"},{"key":"CIT0014-20250902","doi-asserted-by":"crossref","first-page":"247","DOI":"10.22271\/oral.2021.v7.i2d.1217","article-title":"Caries experience in primary molars and first permanent molars among a group of Egyptian children: Cross sectional study","volume":"7","author":"Alkhirbit","year":"2021","journal-title":"Int J Appl Dent Sci"},{"key":"CIT0015-20250902","doi-asserted-by":"crossref","first-page":"9365845","DOI":"10.1155\/2023\/9365845","article-title":"Dental caries and its 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trial","volume":"39","author":"Pascareli-Carlos","year":"2021","journal-title":"J Indian Soc Pedod Prev Dent"},{"key":"CIT0019-20250902","doi-asserted-by":"crossref","first-page":"219","DOI":"10.17796\/1053-4628-41.3.219","article-title":"Effect of papacarie and alternative restorative treatment on pain reaction during caries removal among children: A randomized controlled clinical trial","volume":"41","author":"Khalek","year":"2017","journal-title":"J Clin Pediatr Dent"},{"key":"CIT0020-20250902","first-page":"124","article-title":"Clinical efficacy and pain perception with novel chemomechanical caries removal agent and conventional method in primary molars: A randomized controlled study","volume":"6","author":"Deshmukh","year":"2023","journal-title":"J South Asian Assoc Pediatr Dent"},{"key":"CIT0021-20250902","doi-asserted-by":"crossref","first-page":"131","DOI":"10.22514\/jocpd.2024.066","article-title":"Evaluation of Papacarie\u00ae, Carie-Care\u2122, BRIX3000\u2122 and conventional hand instrumentation for caries removal in primary teeth: A randomized control study","volume":"48","author":"Gupta","year":"2024","journal-title":"J Clin Pediatr Dent"},{"key":"CIT0022-20250902","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/ipd.12364","article-title":"Effects of Papacarie on children with dental caries in primary teeth: A systematic review and meta-analysis","volume":"28","author":"Deng","year":"2018","journal-title":"Int J Paediatr Dent"},{"key":"CIT0023-20250902","first-page":"444","article-title":"Evaluation of the efficacy of caries removal using papain gel (Brix 3000) and smart preparation bur(in vivo comparative study)","volume":"11","author":"Mahdi","year":"2019","journal-title":"J Pharm Sci Res"},{"key":"CIT0024-20250902","doi-asserted-by":"crossref","first-page":"1458530","DOI":"10.3389\/froh.2024.1458530","article-title":"Efficacy of chemo-mechanical caries removal: A 24-month randomized 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