Children’s self-reported discomfort of restorative treatments for deep caries lesions in primary teeth: Results from a randomized clinical trial
DOI:
https://doi.org/10.33448/rsd-v10i16.23837Keywords:
Pain perception; Glass ionomer cements; Patient reported outcome measures; Tooth, deciduous.Abstract
The aim of this study was to evaluate the impact of different restorative techniques to treat deep caries lesions of primary molars on children’s self-reported discomfort. A randomized clinical trial with two parallel arms (1:1) was conducted in São Paulo, Brazil. 4-8 years-old children with at least one occlusal or occlusoproximal deep caries lesion in primary molars were selected. Molars were randomly allocated into two groups: (1) restoration performed with calcium hydroxide cement followed by high-viscosity Glass Ionomer Cement (CHC+HVGIC), and (2) HVGIC restoration. Immediately after the intervention, children reported the experienced discomfort during restoration to an external examiner using a Wong-Baker face-scale. Children’s self-reported discomfort was analyzed using Poisson regression comparing both groups and assessing other variables’ influence (α=5%). One hundred and eight children fulfilled the eligibility criteria and were randomized in the two groups (n=54). Most of the children who received CHC+HVGIC restorations reported none or minimal discomfort (83.3%). Similar scores (92.6%) were reported for those treated with HVGIC (p=0.758). The mean reported discomfort in children with CHC+HVGIC restorations was 0.37(1.01), and 0.41(1.01) for those with HVGIC restorations. Children’s self-reported discomfort was associated with age, sex, children’s cooperation, and intervention duration. We can conclude that CHC+HVGIC or HVGIC restorations result in none or minimal discomfort in the management of deep caries lesions, being considered a reliable option.
References
Abanto, J., Tsakos, G., Paiva, S.M., Carvalho, T. S., Raggio, D. P. & Bönecker, M. (2014) Impact of dental caries and trauma on quality of life among 5- to 6-year-old children: perceptions of parents and children. Community Dent Oral Epidemiol.; 42(5): 385-94.
Bergenholtz, G., Axelsson, S., Davidson, T., Frisk, F., Hakeberg, M., Kvist, T., Norlund, A., Petersson, A., Portenier, I., Sandberg, H., Tranæus, S. & Mejare, I. (2013) Treatment of pulps in teeth affected by deep caries - A systematic review of the literature. Singapore Dent J.; 34(1): 1-12.
Casagrande, L., Bento, L. W., Dalpian, D. M., García-Godoy, F. & de Araujo, F. B. (2010) Indirect pulp treatment in primary teeth: 4-year results. Am J Dent.; 23(1): 34-8.
da Silva, G. S. Q., Raggio, D. P., Machado, G. F. R., Mello-Moura, A. C. V., Gimenez, T., Floriano, I. & Tedesco, T. K. (2019) Impact of different restorative treatments for deep caries lesion in primary teeth (CEPECO 1) - study protocol for a noninferiority randomized clinical trial. BMC Oral Health.; 19(1): 6.
Eren, F., Altinok, B., Ertugral, F. & Tanboga, I. (2013) The effect of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser therapy on pain during cavity preparation in paediatric dental patients: a pilot study. Oral Health Dent Manag.; 12(2): 80-4.
Frencken, J. E., Pilot, T., Songpaisan, Y. & Phantumvanit, P. (1996) Atraumatic restorative treatment (ART): rationale, technique, and development. J Public Health Dent.; 56(3 Spec No):c135-40; discussion 161-3.
Gimenez, T., Bispo, B. A., Souza, D. P., Viganó, M. E., Wanderley, M. T., Mendes, F. M., Bönecker, M & Braga, M. M. (2016) Does the Decline in Caries Prevalence of Latin American and Caribbean Children Continue in the New Century? Evidence from Systematic Review with Meta-Analysis. PLoS One.; 11(10): e0164903.
Gomes, M. C., Perazzo, M. F., Barbosa Neves, É. T., Firmino, R. T., Lopes, R. T., Assunção, C. M., Ferreira, F. M., Paiva, S. M. & Granville-Garcia, A. F. (2021) The Impact of Dental Pain due to Caries in the Oral Health-Related Quality of Life of Children. J Dent Child (Chic).; 88(2): 80-5.
Goud, R. S., Nagesh, L., Shoba, F. & Raju, H. G. (2012) Assessment of Discomfort Experienced by School Children While Performing 'ART' and 'MCP'-An Experimental Study. J Dent (Tehran).; 9(4): 229-37.
Gradella, C. M., Bernabé, E., Bönecker, M. & Oliveira, L. B. (2011) Caries prevalence and severity, and quality of life in Brazilian 2- to 4-year-old children. Community Dent Oral Epidemiol.; 39(6): 498-504.
Guedes, R. S., Ardenghi, T. M., Piovesan, C., Emmanuelli, B. & Mendes, F. M. (2016a) Influence of initial caries lesions on quality of life in preschool children: a 2-year cohort study. Community Dent Oral Epidemiol.; 44(3): 292-300.
Guedes, R. S., Piovesan, C., Floriano, I., Emmanuelli, B., Braga, M. M., Ekstrand, K. R., Ardenghi, T. M. & Mendes, F. M. (2016b) Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation: a 2-year cohort study. Int J Paediatr Dent.; 26(2): 116-24.
Jones, C. M., Davies, G. M., Monaghan, N., Morgan, M. Z., Neville, J. S. & Pitts, N. B. (2017) The caries experience of 5 year-old children in Scotland in 2013-2014, and in England and Wales in 2014-2015. Reports of cross-sectional dental surveys using BASCD criteria. Community Dent Health.; 34(3): 157-62.
Kotsanos, N. & Arizos, S. (2011) Evaluation of a resin modified glass ionomer serving both as indirect pulp therapy and as restorative material for primary molars. Eur Arch Paediatr Dent.; 12(3): 170-5.
Kumar, V., Chawla, A., Logani, A. & Shah, N. (2012) Mineral trioxide aggregate pulpotomy: An ideal treatment option for management of talon cusp. Contemp Clin Dent.; 3(4): 491-3.
Ladewig, N. M., Tedesco, T. K., Gimenez, T., Braga, M. M. & Raggio, D. P. (2018) Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis. PLoS One.; 13(12): e0208437.
Leal, S. C., Abreu, D. M. & Frencken, J. E. (2009) Dental anxiety and pain related to ART. J Appl Oral Sci.; 17 Suppl(spe):84-8.
Lindsay, S. J., Wege, P. & Yates, J. (1984) Expectations of sensations, discomfort and fear in dental treatment. Behav Res Ther.; 22(2): 99-108.
Litt, M. D. (1996) A model of pain and anxiety associated with acute stressors: distress in dental procedures. Behav Res Ther.; 34(5-6): 459-76.
Magnusson, B. (1976) Conservative treatment of deciduous teeth - a review. Dtsch Zahnarztl Z.; 31(6): 474-81.
Marchi, J. J., de Araujo, F. B., Fröner, A. M., Straffon, L. H. & Nör, J. E. (2006) Indirect pulp capping in the primary dentition: a 4 year follow-up study. J Clin Pediatr Dent.; 31(2): 68-71.
Mattos-Silveira, J., Floriano, I., Ferreira, F. R., Viganó, M. E., Mendes, F. M. & Braga, M.M. (2015) Children's discomfort may vary among different treatments for initial approximal caries lesions: preliminary findings of a randomized controlled clinical trial. Int J Paediatr Dent.; 25(4): 300-4.
Mickenautsch, S., Yengopal, V., Bonecker, M., Leal, S. C., Bezerra, A. C. B. & Oliveira, L. B. (2013) MI Compendium: Minimum Intervention (MI) - a new approach in dentistry. J Minim Interv Dent.; 26:1-135.
Novaes, T. F., Matos, R., Raggio, D. P., Braga, M. M. & Mendes, F. M. (2012) Children's discomfort in assessments using different methods for approximal caries detection. Braz Oral Res.; 26(2):93-9.
Rao, A. & Malhotra, N. (2011) The role of remineralizing agents in dentistry: a review. Compend Contin Educ Dent.; 32(6): 26-33; quiz 34, 36.
Santamaria, R. M., Innes, N. P., Machiulskiene, V., Evans, D. J., Alkilzy, M. & Splieth, C. H. (2015) Acceptability of different caries management methods for primary molars in a RCT. Int J Paediatr Dent.; 25(1): c9-17.
Snyder, C. F., Jensen, R. E., Segal, J. B. & Wu, A. W. (2013) Patient-reported outcomes (PROs): putting the patient perspective in patient-centered outcomes research. Med Care.; 51(8 Suppl 3): S73-9.
Srisilapanan, P., Nirunsittirat, A. & Roseman, J. (2017) Trends over Time in Dental Caries status in Urban and Rural Thai Children. J Clin Exp Dent.; 9(10): e1201-e06.
Pascareli-Carlos, A. M., Martins, L. F., Silva Gonçalves, M. D., Pettorossi Imparato, J. C. & Tedesco, T. K. (2021) Pain perception of children after restorative treatments: Atraumatic restorative treatment versus chemomechanical removal - A noninferiority randomized clinical trial. J Indian Soc Pedod Prev Dent.; 39(2): 202-07.
Thompson, V., Craig, R. G., Curro, F. A., Green, W. S. & Ship, J. A. (2008) Treatment of deep carious lesions by complete excavation or partial removal: a critical review. J Am Dent Assoc.; 139(6): 705-12.
Walsh, L. J. & Brostek, A. M. (2013) Minimum intervention dentistry principles and objectives. Aust Dent J.; 58 Suppl 1:3-16.
Wong, D. L. & Baker, C. M. (1988) Pain in children: comparison of assessment scales. Pediatr Nurs.; 14:9-17.
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Copyright (c) 2021 Gabriela Seabra da Silva; Daniela Prócida Raggio; Anna Carolina Volpi Mello-Moura; Thais Gimenez; Juan Sebastian Lara; Isabela Floriano; Tamara Kerber Tedesco
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