A Randomised Controlled Trial Comparing Chemomechanical (Carie-Care™) Versus Conventional Caries Removal for Atraumatic Restorative Treatment

Objective: This study aimed to evaluate and compare the clinical effectiveness of chemomechanical caries removal (CMCR) using Carie-Care™ versus conventional caries removal for atraumatic restorative treatment (ART). Methods: The study included 32 children aged 6-15 years with one or more one-surface cavitated carious lesions on the occlusal surface of permanent dentition. A total of 82 restorations were placed in permanent molars. The teeth were randomly assigned to two groups and monitored for 18 months after the intervention. For Group 1, Carie-Care™ gel was applied directly to the carious lesion, followed by cavity washing and gentle excavation using hand instruments. For Group 2, caries was removed using the mechanical method only. The success rate of the restorations, as well as the time taken and pain reactions measured by the sound eye motor (SEM) scale, were assessed between the two groups. Results: The SEM scores were significantly higher (p  <  0.05) in the conventional ART group than in the Carie-Care™ group. The mean time taken for caries removal in the Carie-Care™ group (731.15 ± 197.48 s) was significantly higher than in the ART group (596.66 ± 158.96 s) (p < 0.001). However, there was no significant difference in the clinical performance of Type IX restoration between the groups (p=0.69). Conclusions: The success rates of the restorations were similar between the two methods. However, the added advantage of less trauma associated with using a chemomechanical agent such as Carie-Care™ makes it an attractive option for community health and school dental programs.