Comparative evaluation of the efficacy of chemo-mechanical caries removal and atraumatic restorative treatment on pain reaction among children: A systematic review and quantitative synthesis

  • Subhashree Mohapatra Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India. http://orcid.org/0000-0002-8068-7249
  • Rahul Mohandas Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, India. http://orcid.org/0000-0002-0609-8219
DOI: https://doi.org/10.17126/joralres.2026.002
Keywords: Dental caries, Dental atraumatic restorative treatment, Papain, Pain, Child, Systematic review

Abstract

Aim: The aim of the systematic review and quantitative synthesis was to assess and compare the efficacy of chemo-mechanical caries removal (CMCR) and atraumatic restorative treatment (ART) on pain reaction among children.
Material and Methods: Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Web of Science, and Google Scholar were searched from the earliest available year till July 15, 2024. PICO Strategy: P: Children; I: Chemo-mechanical caries removal; C: Atraumatic restorative treatment; O: Pain reaction. The review comprised only randomised controlled trials and clinical studies. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool, respectively.
Results: Five full-text publications that met the requirements for eligibility underwent additional processing for data extraction. The overall results of the review suggest that there is no difference in the effect of CMCR and ART on pain reaction among children with a 95% CI of OR: 0.12 [0.01, 1.68]; p=0.12. However, the pooled data suggested high heterogeneity (p<0.0001; I2=89%) among the studies.
Conclusions: The current review concludes that the effect of CMCR and ART on pain reaction among children is comparable. However, the certainty is low due to high heterogeneity among the included studies. Further studies with a combination of subjective and objective scales may help determine the true pain reaction and provide more conclusive evidence for pain reaction to CMCR and ART.

Published
2026-05-07
How to Cite
Mohapatra, S., & Mohandas, R. (2026). Comparative evaluation of the efficacy of chemo-mechanical caries removal and atraumatic restorative treatment on pain reaction among children: A systematic review and quantitative synthesis. Journal of Oral Research, 15(1), 4-19. https://doi.org/10.17126/joralres.2026.002
Issue
Vol 15 (2026): Continuous publication 2026
Section
Reviews
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