Caries Removal Method Research Articles

Evaluation of Microtensile Bond Strength of Artificial Caries Affected Dentin-Adhesive Interface after Using Different Caries Removal Methods (In-Vitro Study)

Evaluation of Microtensile Bond Strength of Artificial Caries Affected Dentin-Adhesive Interface after Using Different Caries Removal Methods (In-Vitro Study)

Alternative methods for caries removal: A narrative review

Dental caries, commonly known as tooth decay, remains a significant global oral health concern. Traditional methods of caries removal, such as mechanical drilling, have proven effective but often result in the removal of healthy tooth structure and may cause patient discomfort.As,, 9a result, alternative methods for caries removal have emerged, aiming to preserve tooth structure, minimize pain, and provide more conservative treatment options. This review article explores various alternative methods for caries removal, including mechanical methods, chemomechanical methods, ultrasonic methods, laser-based techniques, cryotherapy, `silver diamine fluoride, sealants and ozone based approaches.The article summarizes the scientific literature surrounding these methods, including their efficacy, advantages, limitations, and potential applications. Additionally, the article discusses the potential challenges and future directions in the field of alternative caries removal methods. By providing a comprehensive overview of these innovative approaches, this review article aims to contribute to the growing body of knowledge on minimally invasive dentistry and enhance the understanding of alternative techniques for caries removal.

Dentine surface morphology according to caries removal method and subsequent acid etching.

Dentine surface morphology according to caries removal method and subsequent acid etching.

Comparison of pain and efficacy of caries removal using tungsten carbide bur versus chemomechanical agent (Brix Gel): A randomized controlled trial.

Objective: To compare the pain response and efficacy of caries removal using tungsten carbide burs with that of using Brix Gel as a chemomechanical caries removal agent. Study Design: Randomized Controlled Trial. Setting: Department of Operative Dentistry, PIMS, Islamabad. Period: November 2023 to April 2024. Methods: Conducted on 40 participants were selected using a non-probability technique. Participants aged 12 to 65 years with open occlusal carious lesions involving dentin were included. Patients with symptoms of pulpitis, caries affecting maxillary or mandibular anterior teeth, severe systemic illnesses, allergies, sensitivities, or pregnancy/lactation were excluded. Caries removal methods were randomly assigned. Pain levels were assessed using a Visual Analog Scale (VAS), and caries removal efficacy was evaluated. Statistical analysis was done using chi-square and independent samples t test. Results: Among the 40 participants, 47.50% were female, and the mean age was 36.30±15.57 years. Mandibular molars were the most commonly affected teeth (n=24, 60%). No significant difference in age or gender distribution was observed between the two groups. The chemomechanical method resulted in significantly lower pain scores compared to carbide bur (2.59 ± 1.34 vs. 4.44 ± 1.61, p < 0.001). Pain severity also differed significantly between groups, with more mild pain reported in the chemomechanical group (80.00% vs. 5.00%, p < 0.001). However, caries removal efficacy did not significantly differ between the two methods (p = 0.48). Conclusion: Chemomechanical caries removal using Brix Gel demonstrated superior pain management compared to carbide bur. While both methods showed similar efficacy in caries removal, the chemomechanical approach may offer better patient comfort during the procedure.

COMPARATIVE EVALUATION OF BEHAVIOUR OF CHILDREN AND TIME TAKEN BY THREE TECHNIQUES OF CARIES REMOVAL: CHEMOMECHANICAL CARIES REMOVAL, CARIES REMOVAL WITH SMART BURS AND CONVENTIONAL CARIES REMOVAL- A CLINICAL PROSPECTIVE STUDY

Background: Many chemomechanical caries removal (CMCR) agents have been introduced and marketed since 1970s, with each new one being better and effective than the previously introduced. CMCR and Smart Burs (mechanical caries removal) are minimally invasive treatment approaches which selectively remove caries-infected tissue while leaving intact caries-affected tissue-conserving tooth structure. Aim: to compare the effectiveness of different caries removal techniques in primary teeth using the BRIX-3000, conventional caries removal , and Smart Burs in removing dentinal caries. The time taken for caries removal, the efficacy of caries removal and patient acceptance will be evaluated for clinical success with different caries removal techniques. Materials and methods: the study will be carried in thirty primary teeth in children aged 5-10 years with asymptomatic carious lesion. The teeth will be randomly divided into three groups depending on type of caries removal method used. Results: There was statistically significant difference among the groups with respect to childs behaviour , time taken and efficiency of caries removal Conclusion:The time taken to remove caries by Conventional method was observed to be significantly lower as compared to that taken by smart burs and Brix - 3000. The clinical efficacy of caries removal was highest with conventional method followed by almost comparable effectiveness by smart burs and Brix-3000. However,Patient acceptance during caries removal was found to be highest with Brix - 3000 followed by Smart burs and least by Conventional method.

Chemo mechanical caries removal CMCR: Efficacy of Carisolv gel in primary molar teeth.

To evaluate the efficacy of CariSolv gel with respect to chemo-mechanical caries removal in primary molar teeth. The cross-sectional study was conducted at the Department of Paediatric Dentistry, Bakhtawar Amin Dental College and Hospital, Multan, Pakistan, from July to December 2022, and comprised patients of either gender aged 6-12 years having vital, primary molar teeth with clinical and radiographic evidence of carious lesion. Freshly prepared CariSolv gel 0.2 ml to 1.0ml was applied to carious dentine for a minimum of 30 seconds, using chemo-mechanical caries removal hand instruments. The cavity preparation was rinsed and dried. Image caries detector dye was applied by micro brush for 10 seconds. After the cavity preparation was washed and dried, any red-stained dentine indicated residual infected dentine. A maximum of 3 chemo-mechanical caries removal cycles were allowed. Data was analysed using SPSS 26.0. Of the 134 patients, 74(55.2%) were boys and 60(44.8%) were girls. The overall mean age was 8.55±1.58 years. The procedure was successful in 115(85.8%) cases. Age and gender were not significantly associated with the outcome (p>0.05). Chemo-mechanical caries removal method using CariSolv gel was found to be a viable alternative to traditional drilling techniques for caries removal in primary molar teeth.

The Effect Of Different Caries Removal Methods On The Surface Hardness and Micro-tensile Bond Strength

Objective: This study aims to evaluate the effects of five different caries removal methods on caries removal effectiveness according to microhardness and micro tensile bond strength values. Materials: In this study, for the microhardness test, micro-tensile bond strength test (n = 10) SEM analysis (n = 2), and a total of 72 human molar teeth were used. Caries lesions were removed with conventional (steel bur, ceramic bur, polymer bur) methods, chemomechanical method (Brix-3000), and fluorescence-aided caries excavation method (Siroinspect). Then, teeth were sectioned longitudinally through the cavity center and were subjected to the microhardness test, micro tensile test, and SEM atomic analysis. Statistical analyses were performed using one-way ANOVA and Duncan post-hoc tests. Results: A statistically significant difference was found between all caries removal methods and measurement levels at certain distances from the cavity floor (0, 25, 50, 75 μm) (p

Evaluation of dentin features in teeth after caries removal by three techniques (chemomechanical, mechanical with a smart bur, and air-abrasion): an in vitro study.

Different methods for removing dental carious lesions exist, including conventional rotary caries removal and new advanced technology like polymer-based burs, chemomechanical agents, air abrasion, and laser. This study shows the differences in features of dentin (smear layer, patency of dentinal tubules, surface irregularities, intertubular micro porosities, and exposed dentinal tubules) among different types of caries removal techniques. An in vitro study was done on 60 primary molars with occlusal class I active caries. Teeth were divided into three groups according to a method of caries removal (G1: chemomechanical, G2: mechanical with a smart bur, and G3: air-abrasion). After complete caries excavation, the teeth were examined under a scanning electronic microscope (SEM) with the power of magnification 4,000x and 8,000x to show the morphological dentinal features with SEM microphotographs. Data obtained was analyzed using the SPSS program where Fisher exact, Kruskal-Wallis and multiple Wilcoxon sum rank tests were used. The level of significance is when the p-value is less than 0.05. Generally, SEM showed the highest ratio of score 1 of smear layer presence, surface irregularities, and microporosity in all groups in both magnifications. The patency of tubules showed the highest ratio of score 1 in G1, scores 2 in both G2 and G3 in magnification 4,000x, while 8,000x there was the highest ratio of its score 1 in G1 and G2 while the G3 has score 2 as the highest score. The exposed dentinal tubules showed the highest ratio in G1 in score 3, in G2 in score 2, and in G3 in score 1 in magnification 4,000x, while 8,000x there was the highest ratio of its score 2 in both G1 and G3 while the G3 has highest score 1. The study with magnification 4,000x showed a significant difference (S) among three groups in exposed dentinal tubules with a p-value (0.012), and there was S between chemomechanical and smart, chemomechanical and air-abrasions groups with a p-value (0.041, 0.001 subsequentially). Other dentin features showed non-significant differences (NS) among or between groups in both magnifications (4,000x, 8,000x). All groups were effective in removing caries and can successfully treat young, scared or stressed patients. All methods of caries removal produce clinically parametric changes in the residual dentin.

Volumetric analysis after caries excavation with caries detecting dyes and chemomechanical caries removal agents using 3D scanner-a randomised clinical trial

AimThis research aimed to use an extra-oral 3D scanner for conducting volumetric analysis after caries excavation using caries-detecting dyes and chemomechanical caries removal agents in individuals with occlusal and proximal carious lesions.MethodsPatients with occlusal (A1, A2, A3) and proximal carious lesions (B1, B2, B3) were treated with the conventional rotary technique, caries detecting dyes (CDD) and chemomechanical caries removal (CMCR) method on 90 teeth (n = 45 for each). Group A1, B1: Excavation was performed using diamond points. Group A2, B2: CDD (Sable Seek™ caries indicator, Ultradent) was applied and left for 10 s, and then the cavity was rinsed and dried. For caries removal, diamond points or excavators were used. Group A3 and B3: BRIX3000 papain gel was applied with a micro-brush for 20 s and was activated for 2 min, and then the carious tissue was removed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required and the verbal pain score (VPS) for pain were scored during excavation. Post-restoration evaluation was performed at 1, 3, and 6 months FDI (Federation Dentaire Internationale) criteria.ResultsComparison of age, time and volume with study groups were made using Independent Sample’ t’ test and one-way analysis of variance (ANOVA) for two and more than two groups, respectively. Using Cohen’s Kappa Statistics, evaluators 1 and 2 agreed on caries removal status aesthetic, functional and biological properties at different follow-ups. The chi-square test revealed that the rotary groups [A1(2.5 ± 0.4 min) B1(4.0 ± 0.4 min)] had significantly less (p = 0.000) mean procedural time than CDD [A2(4.5 ± 0.4 min) B2(5.7 ± 0.4 min)] and CMCR [A3(5.4 ± 0.7 min) B3(6.2 ± 0.6 min)] groups. The CMCR group showed better patient acceptance and less pain during caries excavation than the rotary and CDD groups. CMCR group showed significantly less mean caries excavated volume(p = 0.000). Evaluation of restoration after 1-, 3-, and 6-month intervals was acceptable for all the groups.ConclusionBrix3000 helps effectively remove denatured teeth with less pain or sensitivity. The time required for caries removal was lowest in the rotary method and highest in the brix3000 group, while the volume of caries removed was the lowest for brix3000 and highest for the rotary group.

Which caries removal method to select?

Searches were carried out using PubMed/MEDLINE and Web of Science databases between January 2008 and January 2023. Only articles in English language were included. Boolean operators were used to search: "permanent teeth" OR "permanent tooth" OR "permanent dentition" AND "deep caries" OR "stepwise" AND "partial caries removal OR "stepwise caries removal" OR "pulp vitality" OR "healing rate". Inclusion criteria were randomised controlled trials, which compared the total removal of carious tissue with either a selective or stepwise removal in permanent teeth with deep carious lesions. Criteria also required a follow up of at least 6 months and publications in English. Exclusion criteria were articles in other languages, articles not comparing different types of total or selective caries removal and articles published before January 2008. Data extraction followed PRISMA guidelines. Two reviewers independently screened articles, analysing titles and abstracts using Rayyan's Intelligent Systematic Review Platform. They also collected data and risk of bias assessed using the Cochrane Risk of Bias Tool for Randomised Trials, dividing articles into high risk of bias, few concerns and low risk of bias. A third researcher resolved conflict or doubt in case of divided opinions. In total, 105 articles were identified, and 10 duplicates removed. 95 articles were reviewed by title and abstract and 75 of these did not meet the inclusion criteria. 20 articles were then read, excluding a further 15 due to comparing only partial removal or non-selective caries removal or absence of numerical data. This left 5 articles which met eligibility criteria. These were randomised controlled trials between 2010 and 2021. Follow up ranged from 1 month to 5 years. The inclusion and exclusion criteria in all studies had similar clinical parameters. 3 studies performed management only on permanent molars, whilst the rest also included management on permanent incisors/canines/premolars and molars. Management of caries was divided into non-selective caries removal vs partial caries removal (either selective or stepwise). All but 2 studies included specific information about the materials used. Liners were calcium hydroxide or Dycal, provisional restorations were glass ionomer cements or Ketax Molar and definitive restorations were Herculite Tetric N-Ceram resin, Ivolclar Vivadent or amalgam. Clinical success or failure was measured using pulp vitality, absence of periapical lesions, radiographic analysis and lack of symptoms. Clinical follow up was evaluated by external examiners, although 2 studies did not specify this clearly. There were a variety of tools used for statistical analysis in each study. When comparing non-selective caries removal with either selective or stepwise, 3 studies proposed statistically significant differences in terms of longevity, marginal integrity and success rate of restorations. 1 study stated inexistence of statistically relevant divergences between procedures. Non-selective caries removal is not highly recommended for deep carious lesions and may be considered invasive and risks pulpal exposure. Both selective and stepwise removal are considered conservative approaches. Selective removal is considered the best management option in the short term (with 1.5 years follow up), predominantly related to a lower risk of pulpal exposure. At 5 years, however, the results of selective were similar to those of non-selective, accepting the null hypothesis. There were also no differences in success rates for materials used for definitive restorations.

Concepts on Chemo-Mechanical Caries Removal Method

Minimal invasive dentistry embraces beliefs that assimilate remineralisation, and inhibition as well as minimal intervention for restorations. By using the least intrusive surgical approach, minimally invasive dentistry affects the treatment objective where a minimal number of healthy tissues are removed. Various methods are now accessible for the excavation of caries. The crudest way to deal with the management of cavities can be done by using hand equipment or instruments, which was an excruciating as well as insufficient strategy for caries removal. Accordingly, the "mission" for more current materials and procedures in the field of caries management led to the utilization of minimally invasive methodologies. Among all the minimally invasive dentistry procedures, the chemo mechanical caries removal method can remove carious tooth material efficiently by hand instruments and a solution. The concept of caries removal by chemo mechanical method reveals the initial diagnosis of carious lesions and helps in minimal destruction of tooth structure during caries removal. This review paper highlights the caries removal methods by the chemo mechanical concept and discusses the various chemo mechanical caries removal agents as well as their properties.

Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study.

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.

Evaluation of the Efficacy of Minimal Invasive Methods Versus Conventional Methods for Caries Removal in Primary Molars.

Evaluating the efficacy of two "minimal invasive methods"of caries removal (Brix 3000/ceramic bur) in comparison with the conventional method in the management of dental caries in primary molars. Materials and methods: A sum of 60 teeth from children ranging from four to nineyears old of both sexes were selected for this study and randomly assigned to three groups: Group I (Brix 3000), Group II (ceramic bur), and Group III (diamond bur), with 20 teeth per group. Regarding the efficacy of caries removal, the Brix 3000 group had significantly the lowest efficacy, while the ceramic bur and diamond bur groups were significantly the highest without significant differences between the ceramic and diamond groups. Regarding caries removal time, the Brix 3000 group was significantly the highest, while the diamond bur group was significantly the lowest, and the ceramic bur group was intermediate between them. Regarding pain perception, the Brix 3000 and ceramic bur groups were significantly the lowest, with insignificant differences between them, while the diamond bur group was significantly the highest. Ceramic bur is an excellent alternative treatment for caries removal in children in comparison with conventional methods and CMCR. Brix 3000®, despite being less painful in comparison with drilling methods, has lower efficacy and efficiency.

The effectiveness of Carie-Care™, chemomechanical caries removal technique in primary teeth: randomized controlled clinical trial

BackgroundChemomechanical techniques for caries removal have been introduced to overcome the shortcomings of the conventional rotatory instruments. This study aimed to clinically evaluate the effectiveness of the chemomechanical method of caries removal (Carie-Care™) over mechanical caries removal through the Atraumatic Restorative Technique in pediatric patients.MethodsA randomized controlled clinical trial was conducted. Fifty children fulfilling inclusion criteria were recruited from the outpatient clinic of Pediatric and Dental Public health department, Faculty of Dentistry, Alexandria University. Fifty open carious primary molars were randomly assigned into 2 equal groups according to the method of caries removal. In Group I (test group), caries was removed using the Carie-Care™ system and in Group II (control group), by using mechanical caries removal through the atraumatic restorative technique. Resin modified glass ionomer was used for teeth restoration, the two techniques were compared in each child according to time taken for caries removal, efficacy of caries removal, pain assessment, and child behavior.ResultsThe mean time taken for caries removal in the Carie-Care™ treatment group was (575.6 ± 114.8) seconds which was statistically significant higher as compared with the ART treatment group (346.1 ± 97.4) seconds (p < 0.001). The mean score of efficacy in caries removal was (0.6 ± 0.8) in the Carie-Care™ group, and (1.3 ± 0.7) in the ART treatment group. When compared to ART, Carie-Care™ was significantly more efficient in caries removal (p < 0.002). When pain was assessed by the SEM scale, it was observed that the Carie-Care™ caries removal technique showed statistically significantly more comfort during the procedure compared with the ART procedure (p < 0.001).Moreover, children in the Carie-Care™ group enjoyed the process and showed more cooperative behavior when assessed at the end of procedure than those in the ART group with statistically significant difference (p = 0.002).ConclusionsRemoval of carious tissue in primary teeth using Chemomechanical Carie-Care™ gel proved to be more time consuming than ART, but on the other hand it was more efficient, comfortable, and accepted by the pediatric patients.

Assessment of Smear Layer Formation After Caries Removal Using Erbium Laser and Papain-Based Chemo-Mechanical Caries Removal Agent: An In Vitro Scanning Electron Microscopy Study.

Introduction With the advancement in the field of adhesive dentistry, there has been a significant and groundbreaking shift towardthe adoption of minimally invasive caries removal techniques where substrate modification is known to enhance adhesive bonding. The smear layer has always been controversial, as its modification helps in bonding, but if contaminated with bacteria, it compromises the formation of a satisfactory marginal seal. Thus, the recognition of the role played by the smear layer highlights the importance of the type of caries removal method employed. Hence, the aim of the present study was to assess and compare smear layer formation after caries removal using an erbium laser and chemo-mechanical caries removal agent by scanning electron microscopy. Methods The study involved the evaluation of 30 extracted human molars with occlusal caries. Based on the method of caries excavation, the samples were allocated into two separate groups: group 1 - caries removed using erbium laser (Waterlase, Biolase, Lake Forest, CA); group 2 - caries removed using papain-based chemo-mechanical caries removal agent (Carie Fix, Dengen Dental, Bahadurgarh, India). To assess the smear layer, the samples underwent examination using a scanning electron microscope at 1500x and 3000x magnification after removal of caries. Statistical analysis was done using SPSS version 22 software (IBM Corp., Armonk, NY). Mann-Whitney test was used to compare the mean smear layer (nonparametric) between both groups. Results Group 1 (Er:YAG laser) showed significantly greater removal of the smear layer than group 2 (papain-based chemo-mechanical caries removal agent) on the excavated caries surfaces(p < 0.001). In group 1, the dentinal tubules exhibited greater patency when compared to the partial patency observed in group 2. Conclusion Both techniques for caries removal were effective; however, the Er:YAG laser method was determined to be more efficient in comparison to the chemo-mechanical agent. These caries removal methods can be considered the future of minimally invasive dentistry.

Evaluation and Comparison of the Efficacy of Chemo-Mechanical, Mechanical Methods of Caries Removal under Self-Illuminated Light Microscope and Stereomicroscope – An In Vitro Study

BACKGROUND&#x0D; There are different caries removal methods including conventional rotary caries removal, atraumatic restorative therapy, air abrasion, lasers, and chemo-mechanical caries removal (CMCR). Chemo-mechanical caries removal is an alternative treatment for active caries, that involves the caries removal of only infected dental tissue and acts by the dissolution of carious lesions with natural or synthetic agents.&#x0D; Aim&#x0D; Comparison of chemo-mechanical material (CariSolv) and the mechanical method (Smart bur &amp; Carbide bur) of caries removal under a self-illuminated microscope and stereomicroscope in terms of efficacy and time duration.&#x0D; METHODS&#x0D; Tooth was sectioned in 4 parts and grouped into 4 as group 1, group 2, group 3, and group 4. Each group was treated with different caries removal methods of carbide bur, smart bur, CariSolv and control group. Examined under self-illuminated and stereomicroscope at 10 different points from middle to periphery.&#x0D; RESULTS&#x0D; Carbide bur specimens have a negligible amount of affected dentin and there is a destruction of dentinal tubules when compared to the smart bur group &amp; CariSolv group. Showing affected dentin thickness in 4 groups at 10 different positions from the middle part of the lesion to the periphery (i.e., towards CEJ &amp; cusp tip) by using a stereomicroscope.&#x0D; CONCLUSIONS&#x0D; The CariSolv group demonstrated the presence of affected dentine higher and took twice the time to remove caries but was easy to induce and conserved the healthy tooth structure when compared to carbide and smart bur groups. Less amount of affected dentine was seen in the carbide bur group but there was a destruction of sound dentine.&#x0D;

Assessing the Acceptability of Less Invasive Caries Removal Techniques for treating Deep Carious Lesions: A Conjoint Survey among Dentists Practicing in a Midwestern American State

This study identified factors that influence dentists’ decisions regarding less invasive caries removal techniques such as stepwise removal (SW) and selective removal (SE) using a marketing research technique, conjoint analysis. A survey was sent to 1,434 dentists practicing in Iowa. Dentists were randomly assigned to receive a questionnaire to rate the likelihood they would use either SW/SE in hypothetical clinical scenarios. The scenarios were carefully created by conjoint design and included three relevant attributes: depth of lesion, hardness of carious dentin, and patient age. Descriptive and conjoint analyses were performed to assess trade-offs between these attributes, using SPSS. The study revealed that depth of lesion was the most important factor in the dentists’ decisions (49 importance value) when choosing a SW to treat a deep carious lesion, followed by hardness of carious dentin and patient age (21 importance value). For the SE group, depth of the lesion was also the predominant factor when selecting a treatment. The study also identified that a high proportion of dentists (24.9%) indicated they would never consider using SW or SE under any circumstances. Our survey showed that depth of lesion was the most important reason to select a less invasive caries removal method. The high proportion of dentists indicating they would never consider selective caries removal (SE) techniques suggests that these less invasive options are underutilized.

Evaluation of the Efficiency of Enzyme-Based Chemomechanical Method in Atraumatic Restorative Treatment of Primary Molars

Aim: To compare clinical and radiographic successes and pain dimensions this chemomechanical agent and traditional Atraumatic Restorative Treatment (ART) method. Material and Methods: Children aged 3-8 years who applied clinic with their parents were included our study (n=38). Teeth included study; Traditional ART method with excavator, enamel chisel and probe and chemomechanical carious tissue removal method with Brix 3000 material were applied. After caries removal methods, restorations were completed with high viscosity glass ionomer cement (YVCIS). After restoration applications, evaluation was made according the Wong Baker Pain Scale. The clinical success restorations was followed up 3, 6 and 12 months according the modified USPHS criteria. Radiographic evaluation was performed 6 and 12 months. In whole study, error value was 5% and load was accepted maintaining the p&lt;0.05 value. Results: 3 and 6 months, there was difference marginal compliance criteria between chemomechanical caries removal and YVCIS restorations applied after traditional ART methods, under surveillance (3rd month p=0.040; 6th month p=0.047). YVCIS restorations applied after chemomechanical caries removal method had Charlie score 2.8% in secondary caries criterion 6th month follow-up. In evaluation made with Wong Baker Pain Scale, facial expression representing no pain expression was preferred most both groups. When all results were evaluated between the two groups, no difference was found when removed (p=0.536). Conclusion: Our study; The chemomechanical caries removal method used non-surgical and acceptable caries removal technique similar the conventional ART method.

Chemomechanical caries removal methods : A review

Chemomechanical caries removal methods : A review

Optimizing Adhesive Bonding to Caries Affected Dentin: A Comprehensive Systematic Review and Meta-Analysis of Dental Adhesive Strategies following Chemo-Mechanical Caries Removal

Although there are several studies that have evaluated the bond strength of various adhesives to healthy dentin and caries-affected dentin after traditional caries removal, the objective of this systematic review aimed to assess the bond strength of various adhesives to caries-affected dentin (CAD) after chemo-mechanical caries removal (CMCR) treatment. The review adhered to PROSPERO protocol registration and followed PRISMA guidelines. The research question focused on the bonding effectiveness of dental adhesives to CAD after employing the chemo-mechanical caries removal method. PubMed, the TRIP database, and Scopus were searched, with the last search conducted in February 2023. Two reviewers independently screened and evaluated articles, resulting in 30 articles for full-text analysis out of 434 retrieved from databases. Twelve eligible studies were included in the review. The bond strength of etch-and-rinse (ER) and self-etch (SE) adhesive systems was assessed following CMCR treatment on CAD. SE adhesive systems exhibited higher bond strength to CAD compared to ER adhesive systems. Meta-analysis indicated that the bond strength achieved with self-etching adhesive systems remained consistent, regardless of the CMCR agent (Carisolv or Papacarie) used on dentin. The findings of this systematic review suggest that self-etch adhesive systems show favorable bond strength to caries-affected dentin following chemo-mechanical caries removal, regardless of the specific CMCR agent used. These results support the use of minimally invasive dentistry techniques aimed at preserving healthy tooth structure, dentin in particular.