Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study.

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.

Chemomechanical caries removal methods: A literature review.

Aim: To provide dental practitioners and researchers with a comprehensive review of the historical development, chemical composition, mechanisms of action, advantages, and drawbacks of different chemomechanical caries removal (CMCR) agents. Methods: An electronic search was performed for all articles published on CMCR agents in various databases, including the Web of Science, PubMed, Cochrane, Scopus, and Google Scholar bibliographic databases, from January 1, 1975, to July 31, 2022. Results: Records were identified using the following search terms: Brix3000, Carie-Care, Caridex, Carisolv, chemomechanical caries removal, conventional surgical method, and Papacárie. A total of 171 articles were screened based on the titles and abstracts, of which 126 were deemed eligible for inclusion after duplicates were removed. Following a manual search of the reference list, eight articles were added. Articles were then excluded for other reasons, such as being written before 1975, being written in a language other than English, and the non-availability of the full text. Overall, 120 articles were included in the analysis (literature reviews [n = 27], systematic reviews [n = 8], research articles [n = 82], case reports [n = 3]). Conclusion: CMCR is a potential method of caries control in the future as an alternative to the conventional surgical approach in standard dentistry applications. It is more widely accepted, less painful, and has comparable efficacy to the conventional surgical method. Clinical significance: A continuous trend among manufacturers has been observed since 1975 to reduce the drawbacks of CMCR agents. Moreover, evidence-based minimally invasive techniques, including CMCR agents that require minimal or no aerosol-generating procedures, are preferred while measures to control the spread of coronavirus disease are in force.

Evaluation of the Efficacy of Minimal Invasive Methods Versus Conventional Methods for Caries Removal in Primary Molars.

AIM: Evaluating the efficacy of two "minimal invasive methods" of caries removal (Brix 3000/ceramic bur) in comparison with the conventional method in the management of dental caries in primary molars.  Materials and methods: A sum of 60 teeth from children ranging from four to nine years old of both sexes were selected for this study and randomly assigned to three groups: Group I (Brix 3000), Group II (ceramic bur), and Group III (diamond bur), with 20 teeth per group. RESULTS: Regarding the efficacy of caries removal, the Brix 3000 group had significantly the lowest efficacy, while the ceramic bur and diamond bur groups were significantly the highest without significant differences between the ceramic and diamond groups. Regarding caries removal time, the Brix 3000 group was significantly the highest, while the diamond bur group was significantly the lowest, and the ceramic bur group was intermediate between them. Regarding pain perception, the Brix 3000 and ceramic bur groups were significantly the lowest, with insignificant differences between them, while the diamond bur group was significantly the highest. CONCLUSION: Ceramic bur is an excellent alternative treatment for caries removal in children in comparison with conventional methods and CMCR. Brix 3000®, despite being less painful in comparison with drilling methods, has lower efficacy and efficiency.

Evaluation of Caries Removal Efficacy Using BRIX 3000 and Atraumatic Restorative Treatment in Primary Molars: A Clinical Comparative Study.

AIM: The aim of the present study was to compare and evaluate the efficacy of two minimally invasive methods in the removal of infected carious dentin in primary molars. MATERIALS AND METHODS: Eighty primary molars with class I occlusal caries involving dentin were selected and allocated to either of the two groups using convenient sampling. Group A (n = 40) caries were excavated using BRIX 3000 and in Group B (n = 40) atraumatic restorative treatment (ART) caries were excavated using hand instruments only. In both groups, caries removal efficacy was evaluated clinically using caries detection dye (Sable and Sleek), and the patient's discomfort level was noted using the Wong-Baker faces pain rating scale (WBFPS). RESULTS: The results indicated that BRIX 3000 was effective in the removal of caries from primary molars with a significant difference. While there was no statistically significant difference seen in pain perception on caries excavation using both the methods. Although, a mild discomfort was noted in Group B. CONCLUSION: Comparing the two minimally invasive techniques, the new chemomechanical solution (BRIX 3000) was an effective method for the removal of caries from primary molars. So, it can be considered an alternative to the conventional caries removal method in treating pediatric dental patients. CLINICAL SIGNIFICANCE: BRIX 3000 gel is effective in the removal of caries in children who are anxious and apprehensive as it is a noninvasive method of treatment in the pediatric age group.

A Bibliometric Analysis (2010-2020) of the Dental Scientific Literature on Chemo-Mechanical Methods of Caries Removal Using Carisolv and BRIX3000.

Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of our research was to provide an overview of the scientific literature on the topic of chemo-mechanical caries removal (CMCR) methods, focusing on two products (Carisolv, BRIX3000), commercially available in Europe. A bibliometric analysis was used to investigate the scientific articles included in Web of Science (WoS) Core Collection database, published from January 2010 to December 2020. We analyzed the co-occurrence of all keywords (Author Keywords and the KeyWords Plus section), co-authorship and co-citation, using the free software VOSviewer. Our bibliometric analysis revealed a worldwide interest in the subject of chemo-mechanical methods of caries removal, which has transcended the area of pediatric dentistry. The analyzed studies have been conducted mainly in high-income countries that have developed sanitary policies regarding prevention and early treatment of carious lesions as a health priority.

Comparative evaluation of BRIX3000, CARIE CARE, and SMART BURS in caries excavation: An in vivo study.

BACKGROUND: Chemomechanical caries removal has been a new leaf for caries excavation in this ultraconservative era of dentistry. BRIX3000 & Carie Care are papain based gel formulations while Smart Burs are polymer burs with self limiting ability. AIM: To compare & evaluate the caries excavation efficacy of BRIX3000, Carie Care & Smart burs. MATERIALS & METHODS: 45 patients with wide class 1 carious lesions were selected and equally divided into 3 groups: BRIX 3000, Carie Care & Smart Burs. Caries excavation was performed in accordance with manufacturer's instructions in each group & evaluation for reduction in bacterial count & mean working time was done. STATISTICAL ANALYSIS: Data was analysed by One way ANOVA, Paired t-Test & Tukey's Post Hoc test. RESULTS: The highest reduction in bacterial count was achieved by BRIX3000(156.93 × 104) followed by Smart Burs(139.07× 104)& Carie Care(135.80×104) with p>0.5. Mean working time in minutes for excavation was: BRIX3000(13.66), Carie Care(18.30) &Smart Burs(20.60) with p< 0.5. CONCLUSION: All the techniques reduced bacterial count potentially. BRIX 3000 proves the most effective among three.

Estudio comparativo entre el uso de brix-3000 y la técnica convencional rotatoria contra la caries / Comparative study between the use of brix-3000 and the rotational conventional technique against tooh decay / Estudo comparativo entre o uso do brix-3000 e a técnica rotativa convencional contra a cárie déntaria

Resumen Objetivo: Verificar la efectividad del gel enzimático a base de papaína BRIX-3000, mediante el procedimiento establecido por los fabricantes para la remoción atraumática de las lesiones cariosas. Materiales y métodos: Es un estudio descriptivo comparativo, de corte longitudinal mediante el cual se aplicó el gel enzimático de papaína BRIX-3000 en 150 pacientes previamente seleccionados en ambos sexos entre las edades de 5 a 12 años. El grupo comparativo estuvo constituido por 31 niños y niñas con caries activa a los cuales se les trató con la técnica rotatoria convencional. Posterior al tratamiento otorgado, los pacientes fueron categorizados en una escala numérica de 0 a 3, donde Grado 0 se refiere al estado asintomático del paciente, Grado 1 cuando la pieza tratada del paciente presenta sensibilidad leve a los estímulos térmicos (frío o caliente), Grado 2 representa el dolor moderado del paciente y Grado 3 corresponde al dolor severo del paciente. Los pacientes fueron controlados a los 8, 15 y 30 días posteriores al tratamiento inicial con el gel enzimático a base de papaína BRIX-3000. Resultados: El 88,70% de pacientes tratados con el gel de papaína BRIX-3000 presentaron grado 0 (asintomático) a los 30 días posterior al tratamiento, mientras que el 58.10% de los pacientes tratados con técnica rotatoria convencional presentaron grado 0. Conclusión: Existe un nivel de efectividad mayor en el tratamiento de lesiones cariosas cuando se utiliza gel enzimático a base de papaína BRIX-3000 en comparación con la técnica rotatoria convencional

Abstract Objective: to verify the effectiveness of the papaine-based enzymatic gelBRIX-3000, following the procedure for the atraumatic removal of carious lesions established by the manufacturers. Materials and methods: This is a descriptive and comparative study based on papain gel application through longitudinal cut. This procedure was performed in 150 previously selected patients of both sexes between the ages of 5 to 12 years. The comparative group consisted of 31 children of both sexes with active caries who were treated with the conventional rotary technique. After the treatment given, patients were categorized on a numeric scale from 0 to 3, where Grade 0 refers to patient's asymptomatic status, grade 1 when patient's treated piece presented mild sensitivity to thermal stimuli (cold or hot), Grade 2 representspatient's moderate pain and Grade 3 corresponds to patient's severe pain. Patients were controlled at 8, 15, and 30 days after receiving the initial treatment with papain gel. Results: 88.70% of patients treated with papaine-based enzymatic gelBRIX-3000presented grade 0 (asymptomatic) at 30 days after treatment, whereas 58.10% of patients treated with the conventional rotary techniquepresented grade0. Conclusion: There is a higher level of effectiveness in the removal of carious lesions when using papaine-based enzymatic gelBRIX-3000 in comparison with the conventional rotary technique.

Resumo Objetivo: verificar a eficácia do gel enzimático à base de papa BRIX-3000, seguindo o procedimento estabelecido pelos fabricantes para a remoção atraumática de lesões cariosas. Materiais e métodos: Trata-se de um estudo descritivo e comparativo de corte longitudinal, baseado na aplicação de gel de papaína. Esse procedimento foi realizado em 150 pacientes previamente selecionados, de ambos os sexos, com idades entre 5 e 12 anos. O grupo comparativo consistiu de 31 crianças de ambos os sexos com cárie ativa que foram tratadas com a técnica rotativa convencional. Após o tratamento, os pacientes foram categorizados numa escala numérica de 0 a 3, onde o grau 0 refere-se ao estado assintomático do paciente, grau 1 quando o paciente apresentou sensibilidade a estímulos térmicos (frio ou calor), grau 2 representa dor moderada do paciente e Grau 3 corresponde à dor severa do paciente. Os pacientes foram controlados aos 8, 15 e 30 dias após receberem o tratamento inicial com gel de papaína. Resultados: 88,70% dos pacientes tratados com gel enzimático à base de papa BRIX-3000 apresentaram grau 0 (assintomático) aos 30 dias após o tratamento, enquanto 58,10% dos pacientes tratados com a técnica rotativa convencional apresentaram grau 0. Conclusão: Existe um nível mas alto de eficácia no tratamento das lesões cariosas ao usar o gel enzimático à base de papa BRIX-3000 em comparação com a técnica rotatória convencional.