Chemomechanical Method Research Articles

Pain related to mechanical and chemomechanical removal of caries in children

The objective of the present study is to compare the pain response associated with the chemomechanical method and hand excavation method during caries removal. Previous studies have indicated that a chemomechanical caries removal system (Carisolv™) has been effective in minimizing the use of conventional mechanical instruments and that it may reduce the need for local anaesthesia. In the present study, a comparison of the pain experienced during treatment with a chemomechanical tecnique and during conventional hand excavation method was carried out in 34 patients. Patients between 4 and 6 years of age were selected for the research. In our study, during the removal of caries some children felt pain both using the Carisolv system and hand excavation method (26.5% and 58.8%, respectively). In the Carisolv group 11.8% of the children wanted local anaesthesia to remove the pain which occurred during the operation; in the hand excavation group 23.5% wanted anaesthesia. In conclusion, the Carisolv system is effective in the removal of caries, causes less pain and need for anaesthesia, decreases the fear, anxiety and stress of children especially created by injectors and drills and increases cooperation.

Microbiological assessment of the chemo-mechanical caries removal

The aim of the study was to assess the efficacy of the chemo-mechani- cal method for caries removal based on microbiological analyses of dentine samples. Sixty freshly extracted teeth with coronaly caries were analysed. In the experimental group (30 teeth) chemo-mechanical caries removal was performed, and in the control group (30 teeth) rotary instruments were used. Before the caries treatment and at the completion of cavity preparation dentine samples were taken by sterile round ISO 012 bur for microbiological analyses. Results of the study showed significant differences between initial and final dentine samples, while differences between the experimental and control group were not significant. The microbiological analyses in the present study imply that the chemo-mechanical method for caries removal is as efficient as the conventional technique.

Chemomechanical caries removal

The purpose of this paper was to introduce Carisolv? system for chemo-mechanical caries removal and its main characteristics, mechanism of action, clinical procedure and the efficacy of this alternative method. New materials and technical and technological development contributed to more precise and efficient work in dentistry. However, problems of rotary instruments for caries removal have remained. Chemomechanical method for caries removal was introduced thirty years ago as an alternative to the conventional mechanical instruments. The technique involved applying a solution onto the carious tissue, allowing it to soften and to remove it without use of drill. Its advantages were: selective removal of carious tissue, absence of pain, reduced need for local anesthesia and reduced potential negative effects to the dental pulp.

Microbiological assessment of the chemo-mechanical caries removal

The aim of the study was to assess the efficacy of the chemo-mechani- cal method for caries removal based on microbiological analyses of dentine samples. Sixty freshly extracted teeth with coronaly caries were analysed. In the experimental group (30 teeth) chemo-mechanical caries removal was performed, and in the control group (30 teeth) rotary instruments were used. Before the caries treatment and at the completion of cavity preparation dentine samples were taken by sterile round ISO 012 bur for microbiological analyses. Results of the study showed significant differences between initial and final dentine samples, while differences between the experimental and control group were not significant. The microbiological analyses in the present study imply that the chemo-mechanical method for caries removal is as efficient as the conventional technique.

Removal of Caries Using only Hand Instruments: A Comparison of Mechanical and Chemo–Mechanical Methods

The aim of this study was to evaluate the efficacy, comfort and efficiency of removing dentin caries using only hand instruments. The Carisolv™ system for caries removal consisting of a solvent gel and a set of specially designed hand instruments (chemo–mechanical) was compared to the use of conventional spoon excavators (mechanical). This was a clinical randomised controlled trial where the two techniques were compared in the same individual. The outcome variables were: complete caries removal; pain during caries removal; anaesthesia requested by the patient during caries removal; time taken to remove caries. Sixty–six individuals, each with a pair of similar cavities in permanent teeth were selected. After caries removal, a ‘blinded’ evaluator assessed the clinical status of the cavity, with the use of a probe. The times for caries removal of the chemo–mechanical and mechanical methods were respectively: 9.2±3.8 and 8.6±3.8 min (p>0.05). There were 4 cavities arguably presenting signs of caries after cavity preparation in the 66 cavities treated with the mechanical method and 7 in the 66 chemo–mechanical cavities (p>0,05). Some pain/discomfort was reported by 21 (32%) participants when the chemo–mechanical method was used, compared with 43 (65%) when the mechanical method was used (p<0.05). During the chemo–mechanical and the mechanical treatment, 2 (3%) and 5 (8%) patients, respectively, requested local anaesthesia (p>0.05). The chemo–mechanical method appeared to be more comfortable for most patients.

A Chemomechanical Method for Caries Removal

Over recent years the dental profession has shifted towards practising preventive dentistry and adopting more conservative and tooth-preserving procedures. Such progression is considered to be a response to the decline in the level of dental caries and advances in materials science. This shift in caries management will no doubt continue over the coming decades, based on rational clinical and scientific principles. Chemomechanical caries removal involves the application of a solution that selectively softens the carious dentine, thus facilitating its removal. This limits the removal of sound tooth structure, the cutting of open dentinal tubules, pulpal irritation and pain compared with conventional mechanical methods.

Evaluation of Carisolv™ for the Chemo–Mechanical Removal of Primary Root Caries in vivo

The objective of this study was to evaluate a new chemo–mechanical method (Carisolv™) for the removal of primary root caries in vivo in terms of efficiency, treatment time and patient perception. Thirty–eight patients participated in an open, randomised and controlled study. Of the 60 root carious lesions included, 34 were randomised for chemo–mechanical treatment and 26 for drilling. A within–subject comparison was used whenever the patient had two cavities, which was the case for 22 subjects. All the Carisolv–treated cavities became caries free, as did all but one of those treated with drilling, as judged by an independent examiner. Only 4 of 34 patients asked for anaesthesia in the Carisolv group compared with 6 of 26 patients in the drilling group. Of those who did not use anaesthesia, 12 individuals in the drilling group experienced some pain compared with none in the chemo–mechanical group (p<0.001). The mean treatment time for the Carisolv method was 5.9 ± 2.2 min, compared with 4.5 ± 2.0 min for drilling; time for anaesthesia excluded (p<0.05). No negative reactions or adverse effects were recorded during the study. All 55 teeth examined in the 1–year follow–up were found to be sensitive using an electric pulp tester, and there was no difference regarding the condition of fillings between the lesions treated with Carisolv and drilling. It can be concluded that root caries can be effectively removed using the Carisolv method. The longer treatment time was compensated by less need for anaesthesia.

Amalgam restorations: A new approach

A conservative approach to amalgam restorations is presented for using a chemomechanical method for softening and removing decay and using a dental adhesive resin for bonding amalgam to tooth structure, reducing the need for mechanical retention and preserving sound tooth structure.

Chemomechanical caries removal--a clinical evaluation.

The aim of this investigation was to evaluate the efficacy and convenience of decayed dentine removal with N-monochloro-DL-2 aminobutyrate (CARIDEX) in all classes of cavities. Fifty-seven patients, each with two teeth having similarly sized carious cavities, participated in this study. One cavity in each patient was treated with the chemomechanical CARIDEX technique and the other cavity was treated with conventional mechanical drilling. The cavities were restored with either amalgam, composite or glass ionomer restorative materials. The time taken for access and caries removal was noted and the efficacy of caries removal with each technique was evaluated. The chemomechanical caries removal technique was effective in removing 90-100% of decayed dentine in 98% of the cavities treated. Multiple regression adjusted access and caries removal time to account for volume of caries removed. This adjusted time was operator dependent, and ranged from 4 to 10 minutes longer for CARIDEX than for the conventional technique. Ninety-three per cent of patients preferred the chemomechanical method of caries removal over the conventional technique (highly significant P less than 0.001). Even though the chemomechanical removal of caries is slower than the conventional technique, the efficacy of CARIDEX and its high patient acceptance provides a viable alternative method for dentinal caries removal in all classes of cavities.