Clinical and Microbiological Evaluation of the Chemomechanical Caries Removal Agents in Primary Molars

Abstract

Background: Chemomechanical caries removal (CMCR) is a noninvasive procedure that uses a chemical substance to remove the diseased dentin. The natural dental architecture is also preserved using this technique, preventing patient discomfort and pulp irritation. This method of eliminating caries is based on disintegration. This method removes soft carious dentin using chemical agents and non-traumatic mechanical force. This study was carried out to evaluate the clinical and microbiological evaluation of the chemomechanical caries removal agents in primary molars.Methods: For the elimination of caries, teeth in category I (polymer bur category) were treated with Smartburs II® (SS White Dental, Lakewood, New Jersey, United States) (n = 40). Teeth treated with the new Carisolv® technology (Mediteam, Sweden) to remove caries (n = 40). Teeth were treated for removal cavities in category III (conventional group) using excavators and carbon steel low-speed round burs from Dentsply Maillefer in Switzerland (n = 40). There was an evaluation of the efficacy of caries removal, the time required for caries removal, patient satisfaction, and microbial culture assessment.Results: In comparison to the other two categories, the conventional category median caries detector dye values were considerably lower (p value<0.05). There was no substantial difference observed between study participants belonging to category I and category II with a p-value greater than 0.05. Time taken during the removal of caries was substantially greater in category I (455.46±73.7) as compared to category II (129.21±44.18) and the traditional category (113.26±37.7). The value of significance was less than 0.05. Contrarily, no discernible difference was observed between category I and category III (the p-value was greater than 0.05). In comparison to the other two categories, the conventional group's median facial expression scale scores were substantially higher (p = 0.02). In comparison, there was no discernible difference between categories I and II (p = 0.65). It was observed that there was no substantial variation in three categories regarding the number of colonies of bacteria prior to the eradication of caries (p-value greater than 0.05). After caries had been removed, the number of living bacterial colonies in category I was noticeably greater than those in the other two categories. However, there was no discernible variation between category II and category 1 (p-value greater than 0.05). Conclusion:The mechanical approach has the highest clinical efficacy for removing caries. Carisolv required the most time to remove cavities. Patient satisfaction levels were greater with Carisolv than with the mechanical approach. It was also observed that Carisolv as well as the mechanical technique had greater antibacterial effectiveness.

Viability and oxidative stress of dental pulp cells after indirect application of chemomechanical agents: An in vitro study

“…New SRCT technologies stand out from conventional techniques, such as direct mechanical removal of carious tissue using burs and manual dentine spoon excavators (Carvalho et al., 2020). Lower invasiveness is among the advantages of chemomechanical agents, promoting higher preservation of the adjacent healthy dentine tissue, reduced pressure for carious tissue removal, higher pulp tissue protection, and more patient comfort, also minimizing the use of anaesthesia, dismissing the noise and aerosol from the motor in the traditional method (Choudhary et al., 2022). These removers show higher population acceptance according to their extensive clinical indication, including paediatric, special needs, and anxious patients, favouring patient cooperation (Alkhouli et al., 2020; Bussadori et al., 2011).…”

“…They demineralize carious dentine, weakening its mineral bonds and making it more fragile through the papain enzyme, a chemical debridement agent with antimicrobial potential and anti‐inflammatory action (Maashi et al., 2023). These properties allow infected dentine removal with manual instruments using lower pressure and in a conservative way compared with traditional dental drills (Choudhary et al., 2022).…”