Abstract

AimTo compare and evaluate morphological changes and bacterial deposits in primary carious molars after caries excavation with Carie-Care, erbium-doped yttrium aluminum garnet (Er:YAG) laser, and round tungsten carbide bur.Materials and methodsThirty human carious primary molars extracted for therapeutic reasons were sectioned mesiodistally. These sectioned samples were allocated into three groups (20 samples each): group I: Carie Care, group II: Er:YAG laser, and group III: round tungsten carbide bur. After caries excavation, all samples were processed and examined under conventional light microscope to examine for bacterial deposits. Representative samples from each group were processed and analyzed to examine the morphology of caries-excavated tissue by scanning electron microscope (SEM). Statistical analysis was done using Fisher’s exact test, Kruskal–Wallis test, and Mann-Whitney U test.ResultsThe Er:YAG laser showed best results with no smear layer followed by chemomechanically excavated surfaces with Carie-Care. Amount of bacterial deposits was observed to be more in group I while least in group II (p-value < 0.001). Mann-Whitney U test and Fisher’s exact test revealed that there was statistically significant difference among all the three groups.ConclusionAmong the three different methods of caries excavation, Er:YAG laser was found to be more effective compared with Carie-Care and round tungsten carbide bur.Clinical significanceLaser-induced caries excavation by Er:YAG laser and chemomechanical method of caries removal by Carie-Care can be considered as future of noninvasive pediatric and preventive dentistry.How to cite this article: Prabhakar A, Lokeshwari M, Naik SV, Yavagal C. Efficacy of Caries Removal by Carie-Care and Erbium-doped Yttrium Aluminum Garnet Laser in Primary Molars: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2018;11(4):323-329.

Highlights

  • Dental caries is ubiquitous in all the population from the very beginning and has encompassed every part of the globe, justifying the wide spread of this pandemic disease since time immemorial

  • The erbium-doped yttrium aluminum garnet (Er):YAG laser showed best results with no smear layer followed by chemomechanically excavated surfaces with Carie-Care

  • Among the three different methods of caries excavation, Er:YAG laser was found to be more effective compared with Carie-Care and round tungsten carbide bur

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Summary

Introduction

Dental caries is ubiquitous in all the population from the very beginning and has encompassed every part of the globe, justifying the wide spread of this pandemic disease since time immemorial. Caries was managed by dentistry through a surgical restorative approach due to inadequate understanding of the actual disease process. This approach led to several replacement procedures, resulting in an increased restoration size or more invasive procedures over the lifetime of the given tooth.[2,3]. Chemomechanical caries removal technique is an alternative approach to traditional caries removal that involves the use of chemical products to soften carious dentin followed by its removal with gentle excavation One such recently introduced material is “Carie Care” gel which is an enzyme-based product aiding in nontraumatic caries removal. The presence of natural antiinflammatory (papain gel) and clove oil (analgesic agent) compounds provide an added advantage to Carie-Care over Carisolv and Papacarie.[5]

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