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The Efficacy of Chemomechanical Caries Removal with Carisolv

Author: WangZuoZuo
Tutor: WuYouNong
School: Nanjing Medical University
Course: Clinical Stomatology
Keywords: Carisolv permanent deciduous molars histological slices HE staining clinic trial
CLC: R781.1
Type: Master's thesis
Year: 2013
Downloads: 5
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With the development of the adhesive dentistry, the dentists have preserved to theminimal intervention dentistry. The Carisolv chemomenchnical caries removalmethod is such a minimally invasive method. Currently, the majority of studiessuggested that the Carisolv could be able to retain more natural tooth structure, andreduce the pain occurrence. However, the efficacy of Carisolv removal caries is stillcontroversial, the previous studies often used a scanning electron microscope toanalyze the residual dentin, but there are still no studies about the demineralized teethsections to evaluate the effectiveness.Part one ReviewMethods: With the systematic review, the literatures about Carisolvchemomenchnical caries removal were recalled in the past11years(2001.01-2011.12),which were indexed by “Medline”, How Net, VIP and so on, while, the hand retrievalwas extended. Analyze and summary the qualified literature on the decades, thequantity and quality. Results: In total272articles,232of them were enrolled,147of them (63.4%) werepublished in Chinese, and85(36.6%) were in English; in which,203(87.5%) werestudies,9(3.9%) were reviews or expert opinion, and20(8.9%) were case reports.The researches on Carisolv were published every year, in the study literature,135were clinic study, and68were experimental research. However, the high-levelrandomized control study is rarely, only about1.3%, most of them were low-levelstudies (34.1%, grade Ⅳ), following were mid-level studies (28.9%, grade Ⅲ).Conclusions: In the past10years, studies about the Carisolv were never discontinuity,and the researches were forced on clinic trials, but of the high-quality were few.Part two Experimental researchMaterials and Methods: In45extracted permanent deciduous molars, the teeth weredivided into three groups. Caries was removed with Carisolv or rotating round burs.Group1, caries were not removed as control; group2, the caries were removed byCarisolv; group3, the caries were removed by rotating round burs. After the cariesremoval had been finished, consecutive decalcified slices (5μm) were sectionedthrough the cavities, stained with hematoxylin and eosin. Light microscope (200×)was used to examine the presence of affected dentine tubules, and the scored wasblinded evaluated in completely removed caries group.Results: The mean scores for complete caries excavation with Carisolv was (0.2845±0.2459), this was no significantly difference, compared with (0.3536±0.2289)with rotating round burs. However, the mean time for caries excavation with Carisolvwas (262.08±53.44) s, which is significantly more consuming than rotating roundburs(68.25±24.33) s.Conclusions: The Carisolv chemo-mechanical method is effective in removal ofcarious tissue, but more time consuming. Part three Clinic researchMethods:36patients(15males and21females)entered a prospective, controlled,randomized study, a total of40carious mandibular molars were selected. Then allteeth were randomly divided into2groups, caries were removed with Carisolvchemo-menchnical or traditional drilling. During both excavation methods, the timespent and pain occurrence was recorded, after the removal of the caries, thecomposite were used to restore the teeth. The clinic follow-up was made at1weekand3month after filling.Results: The time spent for the removal of caries in Carisolv system and in drillingexcavation method was (445±118)s and (124±58)s respectively(P=0.000), and thedegree of pain with Carisolv was significant low(P=0.022). After1week, neither ofgroup complained the spontaneous pain, at the end of3month, differences betweenCarisolv and drilling excavation groups in the terms of marginal adaptation(P=0.732)and anatomic form(P=0.579) were found to statistically insignificant(P=0.517).Conclusions: The Carisolv chemo-menchnical method can reduce the painoccurrence in the excavation, and both the2methods showed a similar clinicalperformance after3months of following up, except the clinic time spending is longerthan drilling excavation.

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