Efficiency of the polymer bur SmartPrep compared with conventional tungsten carbide bud bur in dentin caries excavation

SmartPrep is a rotating instrument for dentin caries excavation made from a special polymer. The manufacturer's product information stated that SmartPrep removes carious dentin selectively. This in vitro study compared the efficiency of SmartPrep with conventional tungsten carbide bud burs. Fifty extracted teeth were split in the center of a carious lesion. The 100 specimens were randomly divided into five groups. Five dentists were asked to excavate 10 teeth each: one half with SmartPrep and the corresponding half with conventional bud burs. The time needed for the caries excavation was measured. Subsequently, histological specimens were produced from all cavities and analyzed by light-microscope after Mallory-Azan-staining. The thickness of the remaining caries was measured (< 1 mm or > 1 mm). The time expended was analyzed using the paired t-test. The results were analyzed for the remaining caries and thickness of the carious layer for every tooth, using the non-parametric Wilcoxon test for combined random samples. A binary logistical regression was performed to determine the influence of the three variables (tooth, sections or bur) on the criteria "caries" or "carious layer thickness (> 1 mm)." The average time to excavate a cavity with SmartPrep was 208.1 seconds, and it was 228.32 seconds with conventional bud burs. The difference between the recorded times was not statistically significant (p > 0.05). In 37 of 50 teeth, the number of carious sections was higher in the SmartPrep group than in the bud bur group. In nine teeth, the quantity of carious sections was higher in the bud bur group than in the SmartPrep group. Four teeth showed no difference in the number of carious sections. The results were statistically significantly different (p < 0.001). In 30 teeth, the number of carious sections with a carious layer thicker than 1 mm was higher in the SmartPrep group compared with the bud bur group. In nine teeth, the number of carious sections was higher in the bud bur group than in the SmartPrep group. Eleven teeth showed no difference in thickness of the carious dentin layer. These results were statistically significantly different (p=0.003). Binary logistical regression showed that only the variable "bur" (bud bur or SmartPrep) influenced the results concerning the criterion "caries" (p < 0.001).