Efficacy evaluation of pepsin enzyme-based gel in chemo-mechanical caries removal on primary anterior teeth: a randomized controlled clinical study / Avaliação da eficácia do gel à base de enzima pepsina na remoção químico-mecânica da cárie em dentes anteriores decíduos: um estudo clínico controlado randomizado

Objective: To evaluate the efficacy of a new pepsin enzyme-based gel compared with Carisolv as a CMCR agent. Clinical and radiographical evaluations of recurrent caries were made 3 and 6 months after treatment. Material and Methods: A split-mouth designed randomized controlled clinical study was carried out on 40 primary anterior teeth of children aged between 4-7 years. Pepsin enzyme-based gel and Carisolv solution were applied to carious lesions until complete removal of caries. The efficacy of both agents was evaluated by the number of application times to remove all caries. Recurrent caries were evaluated clinically and radiographically after 3 and 6 months of treatment. Results: Results showed no statistically significant differences in the efficacy of caries removal by the number of application times (P = 0.919). Concerning recurrent caries, clinical and radiographical evaluation after three and six months showed no statistically significant differences between the two groups (P = 0.574, P = 0.547, respectively). Conclusion: Pepsin enzyme-based gel can be considered similar to Carisolv gel regarding its efficacy as a CMCR agent for small carious lesions on primary anterior teeth in children aged 4-7 years old. (AU)

Objetivo: avaliar a eficácia de um novo gel a base de enzima pepsina comparada com o Carisolv como um agente na remoção químico-mecânica da cárie. Avaliações clínicas e radiográficas de cárie recorrente foram feitas em 3 e 6 meses apos o tratamento. Material e Métodos: um estudo clínico controlado randomizado de boca-dividida foi realizado em 40 dentes deciduos anteriores de crianças com idade entre 4-7 anos. Gel à base de enzima pepsina e a soluçao de Carisolv foram aplicados sobre a lesão cariosa até a completa remoção da carie. A eficácia de ambos agentes foi avaliada pelo número de tempo de aplicações para a remoção de todo tecido cariado. Cárie recorrente foi avaliada clinicamente e radiograficamente após 3 e 6 meses de tratamento. Resultados: Não houve diferença significativa na eficácia de remoção de cárie pelo número de tempo de aplicação (P = 0.919). Em relação à cárie recorrente, avaliação clínica e radiográfica apos 3 e 6 meses mostraram que não houve diferença estatisticamente significante entre os 2 grupos (P = 0.574, P = 0.547, respectivamente). Conclusão: o gel à base de enzima pepsina pode ser considerado similar ao gel Carisolv em relação a sua eficácia como um agente químico-mecânico na remoção da cárie para lesões cariosas pequenas em dentes anteriores decíduos em crianças entre 4-7 anos de idade.(AU)

Psychological influence of mini-invasive Carisolv III gel for caries removal in primary teeth / 医学研究生学报

Objective　Mini-invasive Carisolv is an aid to treat dental caries for patients with dental phobia. The article was to investigate the level of pain in caries removal using mini-invasive Carisolv III gel and mechanical methods with four psychological indicators.　Methods　We collected 120 primary molar tooth caries of 60 children treated in our hospital. Two primary molar tooth caries of each child were respectively treated with Carisolv III gel (Group A) and mechanical method (Group B) for caries removal. Psychological indicators including the visual analog scale (VAS), the Frank1 behavior rating scale (Frank1), the Kuttner law (Kuttner), and the Houpt behavior rating scale (Houpt) were used to assess the level of pain, degree of cooperation, pain tolerance and comfort. The clinical efficiency after six months and treatment time were compared between the two groups.　Results　There was no statistically significant difference before treatment between the two groups using the four psychological indicators (P>0.05) , while significant differences were found during and after the treatment between the two groups (P0.05). In the mechanical group, there were statistically significant differences before and during treatment or before and after treatment using the four psychological indicators (P<0.05). The treatment time in Carisolv III gel group was longer than in mechanical group (P=0.001). There was no statistical difference between the two groups in filling examination after six months (P=0.082).　Conclusion　Carisolv III gel for caries removal can effectively avoid pain, improve comfort and decrease fear in children, which can be promoted in clinical application.

A comparative study of the clinical efficiency of chemomechanical caries removal using Carisolv® and Papacarie® - A papain gel.

Objectives: The purpose of this study was to compare the clinical efficiency of chemomechanical caries removal using Carisolv® and Papacarie® - a papain gel. Materials and Methods: The Carisolv® system for caries removal, consisting of a solvent gel and a specially designed hand instrument, was compared to Papacarie - a papain gel. The outcome variables were: time taken for complete caries removal and volume of carious tissue excavated. Forty patients in the age-group of 20-40 years, having Black's class I dentinal caries with cavity entrance size of ≥3 mm in the molars, were enrolled for the study. The time taken for the complete removal of caries was measured using a stopwatch. Pre- and post-excavation single-step putty/wash elastomeric impression was recorded using addition silicone impression material. Subsequently, casts were poured and measured under a traveling microscope. The total volume of caries excavated was computed using the formula π (d/2)2 h. The difference between the two groups in clinical efficiency and volume excavated was statistically analyzed using the Student's unpaired 't' test. Results: The time for caries removal with Carisolv® and Papacarie® were, respectively, 11.67 ± 3.25 minutes and 10.48 ± 2.96 minutes (P>.05). The mean volume of carious tissue removed with Papacarie® (135.99 ± 66.43 mm 3 ) was higher than that with Carisolv® (126.33 ± 53.56 mm 3 ); however, the difference was not significant. Conclusion: Carisolv® and Papacarie® have similar clinically efficiency as chemomechanical agents for dentinal caries removal.

Carisolv as an endodontic irrigant in deciduous teeth: An SEM study.

Aim: Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. "The purpose of this study was to evaluate the efficacy of Carisolv TM , 1% sodium hypochlorite (NaOCl) gel, and 1% NaOCl solution as root canal irrigants in deciduous anterior teeth." Materials and Methods: Thirty-six extracted deciduous anterior teeth were used. Root canals were flooded with NaOCl solution in Group A, NaOCl gel in Group B and Carisolv TM in Group C and incubated for 30 min. Scanning electron microscope photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored. Results: The results showed that regardless of irrigation regime, canals were consistently cleaner in the coronal and middle thirds than in the apical thirds. NaOCl solution, NaOCl gel, and Carisolv TM had comparable activity at coronal third and middle third of root canals. At the apical third, NaOCl solution cleaned canals better than NaOCl gel and Carisolv TM . Carisolv TM cleaned debris better than NaOCl gel at the apical third. Conclusion: Carisolv TM can be used as an adjunct to root canal preparation.

Efficacy Of Chemo- Mechanical Method (Carisolv ) of Caries Removal With That of Hand Cutting And Rotary Cutting Instruments.

Background and objectives : To evaluate the efficacy of chemo-mechanical method (carisolv) of caries removal with that of hand cutting and rotary cutting instruments with the help of knoop hardness measurements of the cavity floor. Method : The 45 carious molars were subjected to caries detector (Kavo DIAGNOdent) to assess the extent of the lesion before and after the study. The selected samples was divided into 4 groups of 15 teeth each. The first 3 groups were taken as study group Group I (Carisolv), Group II (Hand excavation), Group III (Carbide bur), and Group IV (Control). The treated cavities were cross-sectioned perpendicularly along the long axis of the tooth through the middle of the treated cavity and then subjected to knoop hardness test. Results : The knoop hardness of the remaining dentin thickness was least for group II (hand excavation) and highest excavation for control group IV (normal dentin), group I (carisolv) and group III (carbide bur) showed KHN values that was not statistically significant when compared to group IV. On comparing group I with group III the KHN of remaining dentin thickness of group III was more than group I but this was not statistically significant. Conclusion : It was thus concluded that group II (hand excavation) showed the least knoop hardness value and group I (carisolv) and group III (bur) showed similar to that of normal dentin although values of group III was more than group I but it was not statistically significant.

Resistência de união do adesivo à dentina de dentes decíduos submetidos a dois métodos de remoção químico-mecânica da cárie / Microtensile bond strength of deciduous tooth submitted to different caries removal methods

O objetivo do presente estudo foi avaliar a resistência de união do adesivo à dentina de dentes decíduos após a remoção químico-mecânica da cárie com Papacárie® e Carisolv® e compará-la com o método convencional de remoção com brocas. Trata-se de um ensaio in vitro, cuja amostra foi composta por 15 dentes decíduos cariados esfoliados divididos nos seguintes grupos: Papacárie® - remoção químico mecânica da cárie com Papacárie®; Carisolv® - remoção químico-mecânica da cárie com Carisolv® gel multimix; Controle - remoção mecânica da cárie com brocas esféricas de aço em baixa rotação. Todos os dentes foram restaurados com resina composta Z 100® e armazenados em água destilada a 37 °C por 24h. Os testes de microtração foram realizados com palitos com 0,5 mm2 de área adesiva numa máquina de ensaio universal Emic DL-2000®, na velocidadede 1 mm/min. Os resultados foram submetidos à análise de variância (Anova) e ao teste de Tukey, com um nível de significância de 5%. Os valores médios da resistência de união dos grupos Papacárie® e Carisolv® não mostraram diferença estatisticamente significativa (p = 0,98). No entanto, o grupo de controle, no qual a remoção da cárie foi realizada com o método convencional com brocas foi maior, sendo essa diferença estatisticamente significativa quando comparada ao grupo Papacárie® (p < 0,001) e Carisolv® (p < 0,001). Conclui-se que os métodos de remoção químico-mecânica da cárie, Papacárie® e Carisolv® comportaram-se de maneira semelhante e ambos levaram a uma menor resistência de união do adesivo à dentina do que quando realizada a remoção mecânica com brocas.

Avaliação comparativa do Carisolv na remoção da dentina cariada em molares decíduos: estudo in vitro / Comparative evaluation of Carisolv in removal of carious dentin in primary molar teeth: in vitro study

Objetivo: Avaliar e comparar a eficiência e efetividade do Carisolv na remoção de tecido cariado em molares decíduos. Método: Trinta molares decíduos cariados foram seccionados mésio-distalmente e obtidos 60 espécimes. O Carisolv foi utilizado para remoção do tecido cariado nas 30 seções as quais foram denominadas de Grupo Experimental (GE) e nas 30 seções restantes executou-se a remoção convencional, sendo denominado de Grupo Controle (GC). O tempo gasto para a remoção foi registrado (em minutos) e comparado entre os grupos. Todas as amostras foram analisadas quanto à quantidade de dentina desminaralizada remanescente sob estereomicroscópio. O valores foram registrados em microns. A quantidade de tecido cariado remanescente foi verificada por meio da aplicação de corantes detectores de cárie. Em seguida, a dureza da dentina remanescente foi analisada através da dureza Vicker's, sendo realizada a comparação entre os grupos através do uso do Teste T de Student. Resultados: Verificou-se que os valores médios para a remoção da dentina cariada mostraram-se estatisticamente significante e maiores para o Carisolv (GE) quando comparado à remoção convencional (GC). Ademais, observou-se que a remoção com o Carisolv deixa muito mais quantidade de dentina desmineralizada e a camada de dentina apresenta menor dureza quando comparada à remoção convencional. Conclusão: Carisolv mostrou-se menos efetivo e eficiente quando comparado à remoção de tecido cariado convencional que demanda maior tempo para remoção do tecido cariado. Além do mais, a remoção com Carisolv deixa maior quantidade de dentina desmineralizada, a qual possui menor dureza do que as amostras obtidas com a remoção convencional.

Comparasion of two minimally invasive methods on the longevity of glass ionomer cement restorations: short-term results of a pilot study

The purpose of this study was to evaluate the clinical performance of glass ionomer cement (GIC) restorations comparing two minimally invasive methods in permanent teeth after 12 months. Fifty pregnant women (second trimester of pregnancy), mean age 22 ± 5.30 years, were treated by two previously trained operators. The treatment approaches tested were: chemomechanical method (CarisolvTM; MediTeam) and atraumatic restorative treatment (ART). A split-mouth study design was used in which the two treatments were randomly placed in 50 matched pairs of permanent teeth. The chemomechanical method (CM) was the test group and the ART was the control group. The treatments were performed in Public Health Centers. The tested restorative material was a high-strength GIC (Ketac Molar; 3M/ESPE). The restorations were placed according to the ART guidelines. Two calibrated independent examiners evaluated the restorations in accordance with ART criteria. The inter-examiner kappa was 0.97. Data were analyzed using 95 percent confidence interval on the binomial distribution and Fisher's exact test at 5 percent significance level. In a 12-month follow-up, 86 percent of the restorations were evaluated. In the test group (CM), 100 percent (CI=93.3-100 percent) of the restorations were considered successful. In the control group (ART) 97.6 percent (CI=87.4-99.9 percent) of the restorations were considered successful and 2.4 percent unsuccessful (marginal defect >0.5 mm). There was no statistically significant difference between the 12-mounth success rate for both groups (Fisher's exact test: P=0.49) and between the two operators (Fisher's exact test: P=1.00). Both minimally invasive methods, chemomechanical method and ART, showed a similar clinical performance after 12 months of follow up.

The efficacy of chemo-mechanical removal of dentin carious lesion / 대한치과보존학회지

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). 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.