This randomized clinical trial evaluated OptraDam, a clamp-free dental isolation system, in 44 children requiring pulpotomy of primary molars. Participants were randomized to OptraDam (n = 22) or conventional rubber dam isolation (n = 22). The groups were comparable in age, sex distribution, baseline anxiety scores, and heart rate. Dental anxiety was assessed using the Venham Anxiety Scale, while heart rate and the Sound–Eye–Motor (SEM) scale assessed physiological stress and behavioral responses.

SEM scores during the procedure were significantly lower with OptraDam. Mean baseline-minus-post-treatment changes in Venham Anxiety Scale scores were 0.68 ± 1.64 with OptraDam and −1.41 ± 1.82 with conventional rubber dam isolation, yielding a between-group difference of 2.09 points (95% confidence interval [CI], 1.04–3.15; P < 0.001). Heart rate changes were 4.23 ± 10.45 beats/min and −18.91…