Abstract
The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.
Highlights
The aim of this study was to compare the efficacy of chemochemical methods (CarisolvTM and Papacárie®) versus the manual method in reducing the cariogenic microbiota in dentine caries of primary teeth
Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study
Previous studies reported similar results with primary teeth, showing that CarisolvTM did not improve the reduction of cariogenic microbiota in dentine caries, compared with manual excavation,[14,15] or drilling.[13,15]
Summary
The chemomechanical system was developed over 30 years ago, it only started to gain attention in the late 90s, when CarisolvTM was released on the market and began to be used widely. This system involves application of a gel composed of an amino acid solution and sodium hypochlorite, which are able to dissolve collagen fibers degraded. By caries, facilitating their removal by appropriated manual instruments.[8,10] In order to disseminate the large-scale use of the chemomechanical method to remove carious dentine, and considering the high cost of CarisolvTM, a proteolytic gel named Papacárie® was released in Brazil. Papacárie® combines the collagen degradation effect of papain (a natural protease) and the bactericide effect of chloramines.[9,11]
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