J Korean Acad Conserv Dent. 2005 May;30(3):149-157. Korean.
Published online May 31, 2005.
Copyright © 2005 Korean Academy of Conservative Dentistry
Original Article

The efficacy of chemo-mechanical removal of dentin carious lesion

Soon-Bin Lim,1 Kyung-Kyu Choi,1,2 and Sang-Jin Park1,2
    • 1Department of Conservative Dentistry, Division of Dentistry, Graduate School, Kyunghee University, Korea.
    • 2Oral Biology Research Institute, College of Dentistry, Kyunghee University, Korea.
Received July 01, 2004; Revised September 21, 2004; Accepted November 23, 2004.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mechanical removals in decayed teeth have been performed using drill and sharp hand instruments. These methods have some disadvantages such as pain, local anesthesia and overextended cavities. Therefore chemo-mechanical excavation of dentin carious lesions has been introduced. The purpose of this study was to evaluate the efficacy of traditional mechanical methods using burs and chemo-mechanical methods (Carisolv) of caries dentin.

Mechanical caries removal was carried with low speed round bur. Chemo-mechanical caries excavation was performed with Carisolv (Medi-team), using the Carisolv hand instruments. The mean time to remove caries with two different methods was evaluated and the data analyzed with SPSS software (ver 11.5) by t-test (p < 0.05). For histomorphometry of caries removal were also carried with mechanical or chemo-mechanical (Carisolv) methods from 20 extracted caries permanent molars. Complete caries removal was verified with a #23 sharp explorers, Caries Detector (Kuraray Co. Japan), and standard apical radiography.

1. Chemo-mechanical method was taken more times than mechanical method (1.5 fold) (p < 0.05).

2. Excavation for caries took more time for molar lesion than premolar lesion, and the least time was taken to remove the caries in incisor lesion (p < 0.05).

3. There were no significant differences to remove the caries between the maxilla and mandible (p > 0.05).

4. The remaining carious dentin was detected after the chemo-mechanical removal of the carious dentin, and no smear layer were seen after the mechanical and chemo-mechanical removal of the carious dentin.

Keywords
Chemo-mechanical method; Caries; remaining caries; Carisolv; Standard apical radiography; Mechanical removal

Figures

Figure 1
The mean time for Caries removal with two methods.

Figure 2
The mean time for Caries removal in Maxillary and Mandibular teeth (*Mx = Maxilla, *Mn = Mandible).

Figure 3
Chemo-mechanical method <100×>.

Figure 4
Chemo-mechanical method <400×>.

Figure 5
Mechanical method <100×>.

Figure 6
Mechanical method <400×>.

Figure 7
Carisolv gel, Special instruments (Medi-Team. Sweden), #23 Explorer, and Caries Detectors. (Kuraray co. Japan)

Tables

Table 1
Classification of caries teeth used by two different caris removal methods in three groups (N = 303)

Table 2
The mean time for caries removal with two methods (Unit: min, Mean ± S.D)

Table 3
The mean time for caries removal in Maxillary & Mandibular teeth(min) (Unit: min, Mean ± S.D)

References

    1. Banerjee A, Kidd E, Watson T. In vitro evaluation of five alternative methods of carious dentine excavation. Caries Res 2000;34:144–150.
    1. Banerjee A, Kidd E, Watson T. Scanning electron microscopic observations of human dentine after mechanical caries excavation. J Dent 2000;28:179–186.
    1. Yamada Y, Hossain M, Kawanaka T, Kinoshita J, Matsumoto K. Removal effects of the Nd:YAG laser and Carisolv on carious dentin. J Clin Laser Med Surg 2000;18:241–245.
    1. Yamada Y, Hossain M, Suzuki N, Kinoshita JI, Nakamura Y, Matsumoto K. Removal of carious dentin by Er: YAG laser irradiation with and without carisolv. J Clin Laser Med Surg 2001;19:127–131.
    1. Beeley JA, Yip HK, Stevenson AG. Chemochemical caries removal a review of the techniques and latest developments. Br Dent J 2000;188:427–430.
    1. Ericson D, Zimmerman M, Raber H, Gotrick B, Bornstein R, Thorell J. Clinical evaluation of efficacy and safety of a new method for chemo-mechanical removal of caries. A multi-centre study. Caries Res 1999;33:171–177.
    1. Chaussain-Miller C, Decup F, Domejean-Orliaguet S, Gillet D, Guigand M, Kaleka R, Laboux O, Lafont J, Medioni E, Serfaty R, Toumelin-Chemla F, Tubiana J, Lasfargues J. Clinical evaluation of the Carisolv chemomechanical caries removal technique according to the site/stage concept, a revised caries classification system. Clin Oral Investig 2003;7:32–37.
    1. Munshi AK, Hegde AM, Shetty PK. Clinical evaluation of Carisolv in the chemico-mechanical removal of carious dentin. J Clin Pediatr Dent 2001;26:49–54.
    1. Hannig M. Effect of Carisolv™ solution on sound, demineralized and denatured dentin - an ultrastructural investigation. Clin Oral Investig 1999;3:155–159.
    1. Kakaboura A, Masouras C, Staikou O, Vougiouklakis G. A comparative clinical study on the Carisolv caries removal method. Quintessence Int 2003;34:269–271.
    1. Splieth C, Rosin M, Gellissen B. Determination of residual dentine caries after conventional mechanical and chemomechanical caries removal with Carisolv. Clin Oral Investig 2001;5:250–253.
    1. Maragakis GM, Hahn P, Hellwig E. Clinical evaluation of chemo-mechanical caries removal in primary molars and its acceptance by patients. Caries Res 2001;35:205–210.
    1. Nadanovsky P, Cohen Carneiro F, Souza de Mello F. Removal of caries using only hand instruments: a comparison of mechanical and chemo-mechanical methods. Caries Res 2001;35:384–389.
    1. Fure S, Lingstrom P, Birkhed D. Evaluation of Carisolv for the chemo-mechanical removal of primary root caries in vivo. Caries Res 2000;34:275–280.
    1. Wennerberg A, Sawase T, Kultje C. The influence of Carisolv on enamel and dentine surface topography. Eur J Oral Sci 1999;107:297–306.
    1. Arvidsson A, Liedberg B, Möller K, Lyvén B, Sellén A, Wennerberg A. Chemical and topographical analyses of dentine surfaces after Carisolv™ treatment. J Dent 2002;30:67–75.
    1. Haak R, Witch MJ, Noack MJ. Does chemo-mechanical caries removal affect dentine adhesion? Eur J Oral Sci 2000;108:449–455.
    1. Cederlund A, Lindskog S, Blomlof J. Effect of a chemomechanical caries removal system (Carisolv) on dentin topography of non-carious dentin. Acta Odontol Scand 1999;57:185–189.
    1. Cederlund A, Lindskog S, Blomlof J. Efficacy of Carisolv-Assisted caries excavation. Int J Periodontics Restorative Dent 1999;19:464–469.
    1. Dammaschk T, Stratmann U, Mokrys K, Kaup M, Ott K. Histocytological evaluation of the reaction of rat pulp tissue to Carisolv. J Dent 2001;29:283–290.

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