Worldwide research trends on the use of chemical–mechanical caries removal products over the years: a critical review

Abstract

Background Chemical–mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. Aim Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. Design Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. Results 2221 records were identified, 397 selected. 2011–2020 period concentrates higher number of publications ( n = 169), in the Journal of Dental Research ( n = 51), developed in Brazil ( n = 45) and India ( n = 44). Most studies were in vitro ( n = 211) and clinical trials ( n = 101). Carisolv™ ( n = 48) and Papacarie Duo Gel™ ( n = 33) were the most used products, prescript in isolated usage ( n = 101), and compared with drills ( n = 77). CMCR were more studied in primary teeth ( n = 78), receiving glass ionomer cement (GIC) ( n = 51) as restorative material. The most evaluated outcomes were time spent ( n = 48) and pain ( n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. Conclusion In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments’ time.

Current Concepts on Caries Removal

“…Consequently, dental and health professionals cautioned against overusing aerosol-generating therapies during the outbreak. Given the aforementioned suggestions, utilizing CMCR products that need little to no aerosol-generating techniques instead of surgery in caries prevention may be more proficient for people of all ages, especially those who suffer from anxiety or have special needs [34].…”

Chemical-Mechanical Agents Versus Rotary Systems for Caries Removal: A Systematic Review of In Vitro Studies

“…Therefore, less invasive methods have been analyzed (5,6). The first generation of chemical-mechanical agents (CMA) used sodium hypochlorite (NaClO) and, subsequently, papain-based products, such as Papacarie Duo Gel, Carie Care, and Brix 3000, became available (7).…”

Chitosan flakes for papain immobilization: improving the stability and reusability of the enzyme

“…In today's global chemicals landscape, the focus is squarely on biomolecules like enzymes, renowned for their exceptional catalytic efficiency. Among them, proteases lead the way, comprising 60% of worldwide enzyme sales and finding utility in diverse industries spanning detergents, leather, textiles, food, and pharmaceuticals (Matkawala et al, 2022;Souza et al, 2022). Additionally, plant-derived enzymes such as papain, bromelain, and ficin have carved out their own place in various sectors, from meat tenderization to juice and beer clarification, cosmetics, textiles, baking, cheese production, edema treating, wool antishrinking, amino acid production and beyond (Shin et al, 2020;Benucci et al, 2020;Moreira Filho et al, 2020;Shouket et al, 2020).…”