الفهرس 
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Abstract
The change in the concepts of cavity preparation and the advent of reliable adhesive systems lead to the development of alternative methods of caries removal. A clinical trial was conducted to compare the clinical efficacy and pain reaction of three minimally invasive methods, alternative restorative treatment (ART), a chemo-mechanical caries removal method (Carisolv) and the polymer bur (SMARTBURS II).
The study included 60 primary teeth, children aging 4-8 years. Children were selected from those attending the outpatient clinic, Pediatric Dentistry Department, Faculty of Dentistry, Alexandria University. Each child had a primary tooth showing an class V carious lesion. The study sample was randomly assigned into three comparative groups according to the method of caries removal. Group I in which caries was removed using the ART, Group II which caries was removed using the Carisolv approach and Group III which caries was removed using the SMARTBURS II approach.
Following caries removal, the efficacy of caries removal for caries removal and the pain reaction were recorded for three groups. Then the cavities were restored using Fuji IX glass ionomer.
The results showed that the efficacy of caries removal were significant differences between the three groups. The score ranged between 0-1. Both ART and Carisolv demonstrated 100% caries removal while only 30% SMARTBURS II showed complete caries removal. This was significantly different (p< 0.001).
As regards the pain assessment according to the SEM scale, all cases demonstrated a mean score 1 (comfort) and there was no statistically significance difference between the three groups. Regarding to the pain assessment according to Wong-Baker FACES Pain Rating Scale. There were significant differences between the three groups. The score ranged between 0 (no hurt) and 2 (hurts little bit). 100% of the ART group demonstrated no hurt, 95% of Polymer bur group demonstrated no hurt and 5% demonstrated hurts little bit and 75% of the Carisolv group demonstrated no hurt and 25% demonstrated hurts little bit. The ART group expressed significantly less pain (no hurt) compared to the Carisolv group (p< 0.018).