Polymer And Steel Burr Case Study

COMPARATIVE EVALUATION OF POLYMER AND CERAMIC BURS IN SELECTIVE CARIOUS DENTIN REMOVAL
Aim: The aim of the study was to evaluate and compare theclinical efficacy and patient perception of steel bur, polymer and ceramic bur in caries excavation.
Study design
40 children in the age group of 8-14 years with at least three occlusal carious lesions in any of the maxillary/mandibular first permanent molars were included in this study. The selected carious first permanent molar teeth in each patient were randomly assigned to receive restoration after cariousdentin removal withthe Steel bur group, Polymer bur group and the Ceramic bur group by using the lottery method. All the procedure was completed by a single operator in one appointment. The clinical
The steel bur takes less time, followed by polymer and ceramic burrs. In patient perception, the Polymer bur was found to be more satisfactory followed by Ceramic bur and Steel bur. The steel and ceramic burs shows consistency in the longevity of the restoration even after 6 months when compared to polymer bur.
Conclusion
The Polymer and Ceramic bur exhibit promising trends for the effective caries removal and patient acceptance.
Keywords: Caries excavation, caries removal, Steel bur, Polymer bur, SmartPrepbur, Ceramic Bur, Cera bur
INTRODUCTION
Traditionally caries removal was accomplished using rotary carbide burs andhand instrumentsto excavate until it feels as hard as normal dentin. Thisprocedure is somewhat imprecise because it is practically impossible to provide aclinical description of the boundary between infected and non- infected dentin.Further, the traditional approach is not fundamentally conservative because it oftenresults in cavity preparation that extends beyond the infected outer carious dentin intothe non-infected or lightly infected inner carious dentin or into normal dentin. 1Dentalcarbide burs are designed to efficiently remove non-decalcified enamel and dentin anddo not readily differentiates between carious and normal dentin.
PATIENT PERCEPTION OF THE PROCEDURE
Patient perception of the procedure was carried out after excavation of each tooth using close ended interview based questionnaire. That included questions on pain and discomfort. The pain was assessed using “WONG-BAKER FACES PAIN RATING SCALE.” The answer was recorded as ‘yes’ or ‘no’ on the questionnaire form.
The excavated cavities were then restored with Reinforced Glass Ionomer Cements Fuji IX (GC corporation, Tokyo, Japan), as interim restoration, with placement of a calcium hydroxide base (Dycal®, Dentsply, LD Caulk, USA). The restorations were checked for high points using articulating layer paper and the restoration was coated with a layer of Varnish (Namuvar, India).

IV. Evaluation of restoration by digital radiography
Following placement of the restoration, a digital radiograph (Intraskan digital radiography) was taken to facilitate immediate evaluation using a scoring criteria proposed by Munshi AK and co-workers. (3,14)(Table no:-2)

Table no:-2-Criteria for evaluation of the longevity of restorations 3, 14

Score Criteria
0 Restorations present; no gap between the cavity walls and restoration
1 Gap and/or restoration partially present; no signs of