The effect of polymer burs on microbiological reduction of carious dentin in deciduous teeth: a systematic review

Background. Polymer bur is a new technology that proposes to conserve the dentin that is capable of remineralization. Aim: To conduct a quantitative systematic review to evaluate the effect of polymer burs on the reduction of Streptococcus mutans and Lactobacillus after dentin carious excavation in deciduous teeth. Methods and Material: Two reviewers performed the database to identify the relevant clinical papers. Only papers in English that compared polymer burs with other caries removal techniques with the microbiological aspects as an outcome were included. Papers that evaluated only permanent teeth were excluded. Risk of bias was also assessed. Individual study effect sizes were calculated using Cohen’s d formula for the comparisons of microorganism reduction before and after carious excavation. Results: The search resulted in 12 non-duplicated papers. After the revision, only 2 were selected. The quantitative evaluation demonstrated that polymer bur reduces microorganism levels in carious dentin. The larger effect size observed was for Streptococcus mutans in the polymer bur technique (r=0.84; d=3.12), followed by Lactobacillus in the carbide bur technique (r=0.83; d=3.03). Conclusion: Polymer burs promoted a significant reduction of microorganism levels, mainly Streptococcus mutans in carious dentin.