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Title Polymer Burs Remove Less Sound Dentin and are as Effective as Carbide Burs in caries Removal
Clinical Question In a patient with dentin caries, is the use of a polymer bur compared to a conventional round bur more effective in selectively removing carious dentin?
Clinical Bottom Line Polymer burs were found as effective as carbide buds in caries removal. They remove less sound dentin and conserve more tooth structure than traditional round burs.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20836951Isik/201024 patients with 2 active carious lesions on primary molars.Randomized Controlled Trial
Key resultsThere were statistically significant differences in the number of colony forming units per milliliter for both types of burs before and after preparation (P<0.05). However, in comparing the two burs after preparation, there were no statistically significant differences in the reductions of CFU/ml (P>0.05).
#2) 17645069Hauman/200720 non-carious extracted molars In Vitro Study
Key resultsA statistically significant difference was found (p<0.05) between mean healthy dentin loss after treatment with polymer burs (1.4-9.0 mg) and mean healthy dentin loss after treatment with stainless steel round burs (7.6-16.5 mg). Dulling of the blades of the polymer burs was observed as well as the production of dentin “flaking” with the stainless steel round burs.
Evidence Search "Polymer"[All Fields] AND "Burs"[All Fields] AND "Dentin"[All Fields]
Comments on
The Evidence
The Isik study is a randomized controlled clinical trial that used a low sample size. The Hauman study was an evaluation study with a very low sample size that was done on extracted teeth as opposed to a clinical setting. In both studies, there was a more than 80% completion rate, no competing interests were found, and recall bias was unlikely.
Applicability The polymer bur was found to remove caries as effectively as traditional round burs while conserving more dentin. Bonding, restoration longevity and tooth longevity are dependent on conserving as much dentin as possible.
Specialty/Discipline (Endodontics) (Pediatric Dentistry) (Restorative Dentistry)
Keywords dentin caries, polymer burs, steel round burs
ID# 2206
Date of submission: 04/09/2012spacer
E-mail andrader@livemail.uthscsa.edu
Author Rebeka Andrade
Co-author(s) e-mail
Faculty mentor/Co-author Rita Renee Parma, DDS
Faculty mentor/Co-author e-mail parma@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Priya Patel, Joey Dickson (San Antonio, Texas) on 11/30/2017
A November 2017 PubMed search found a randomized control study by Aswathi, 2017 (PMID# 28139476) and in-vitro comparative study by Divya, 2015 (PMID #26393204). Both pieces of evidence indicate that polymer burs are minimally invasive when it comes to removing carious dentin. Also, Polymer burs generate less heat and provide minimal discomfort during caries excavation. However, the two pieces of evidence detour in regard to microbial counts post excavation. Further study is needed to examine this conflict in data.

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