Pain Assessment During Extraction of Lower Primary Molars in Children: A Comparative Study of Physics Forceps and Conventional Forceps (Clinical Study)

Abstract

Background: Extraction of primary molars represents one of the most frequently performed interventions in pediatric dentistry and is commonly associated with postoperative discomfort and pain of varying severity. Pain intensity is modulated by several factors, foremost among which are the extraction technique employed and the specific type of forceps utilized. These considerations highlight the importance of comparative studies evaluating the effects of conventional forceps and Physics Forceps on patient comfort and overall treatment experience. Objective: This study aimed to compare the severity of pain following the extraction of lower primary molars using Physics Forceps in comparison to conventional forceps. Pain evaluation was conducted in pediatric patients employing the modified Wong-Baker Faces Pain Rating Scale.

Materials and Methods: A prospective randomized clinical trial was performed involving 80 healthy children aged 6 to 9 years from the Pediatric Dentistry Department, Faculty of Dental Medicine, Damascus University, all requiring extraction of lower primary first and second molars. Participants were randomly assigned to four groups: The Physics Forceps group (n=40 teeth: 20 primary first molars, 20 primary second molars) and the conventional forceps group (n=40 teeth: 20 primary first molars, 20 primary second molars). Postoperative pain was assessed using the modified Wong-Baker Faces Pain Rating Scale at T0 (post-local anesthesia), T1 (immediately post-extraction), and T2 (2 hours post-extraction). Results: Evaluation of postoperative pain using the modified Wong-Baker Faces Pain Rating Scale revealed statistically significant differences, with the Physics Forceps group showing markedly lower pain levels immediately after extraction and at the two-hour follow-up compared to the conventional forceps group (p < 0.05). Despite higher initial pain scores following local anesthesia in the Physics Forceps group, these findings demonstrate the technique's overall effectiveness in reducing pain during and after the procedure.

 Conclusion: Physics Forceps represent a valuable atraumatic tool for pediatric tooth extraction , it offers a clear clinical advantages in pediatric extractions by reducing postoperative pain, improving child comfort, and enhancing the overall dental experience compared to conventional methods.