Comparsion of the efficacy of chemomechanical and mechanical methods of caries removal in the reduction of streptococcus mutans and lactobacillus spp in carious dentine of primary teeth

Abstract

The methods of caries removal have been the subject of many studies over the last years. At present, methods involving the least tissue invasion have been outstanding in the field of surgical-restorative treatment. In this context, the Carisolv™ system has appeared as a less traumatic and less invasive approach, particularly in pedodontics. Thus, the objective of the present study was to carry out a comparative analysis of the dentinal structure of primary molars before and after the removal of carious tissue by mechanical (low speed drills and conventional dentinal curettes) and chemomechanical (Carisolv™ kit) procedures based on quantitative culture for cariogenic bacteria to determine the number of bacteria present in the carious dentine after both treatments. Sixty primary molars from children ranging in age from 4 to 8 years, with active occlusal caries in dentine, were divided into two groups (A and B) of 30 teeth each, with group A having been treated by the chemomechanical technique and group B by the mechanical technique. Dentin samples were placed in glass vials containing 1 mL thioglycolate broth and submitted to culture to determine the number of S. mutans and Lactobacillus per mg of decayed dentine. The results did not reveal significant differences between the two methods of caries removal; however, the chemomechanical method was more efficient in completely eliminating S. mutans (p=0.02). In summary, the present results confirm previous studies showing that the two methods are comparable in reducing Lactobacillus, but Carisolv™ is more effective in the elimination of S. mutans.

Efficacy of chemomechanical caries removal in reducing cariogenic microbiota: a randomized clinical trial

“…in dentine caries, compared with manual excavation, 14,15 or drilling. 13,15 Conversely, in a clinical study, the reduction of cariogenic flora after caries removal was attributed to the antibacterial properties of Carisolv ™ , which has amino acids and sodium hypochlorite in its composition.…”

“…in dentine caries, compared with manual excavation, 14,15 or drilling. 13,15 Conversely, in a clinical study, the reduction of cariogenic flora after caries removal was attributed to the antibacterial properties of Carisolv ™ , which has amino acids and sodium hypochlorite in its composition. 16 Differences in selection criteria, sampling procedures and bacterial culture techniques could explain the controversial results in studies assessing antimicrobial efficacy of the chemomechanical methods.…”

“…16 Differences in selection criteria, sampling procedures and bacterial culture techniques could explain the controversial results in studies assessing antimicrobial efficacy of the chemomechanical methods. 13,14,15,16 Some studies used a specific size of sterile bur to collect the dentine samples, 12,13,16 whereas others used a manual sterile excavator 14,15 or the specific Carisolv ™ excavator. 16 In the present study, dentine samples were collected with a sterile excavator (11 1/2 Duflex ™ ).…”

“…The active part of the same dentine excavator (11½ Duflex ™ ) used in the first and the second dentine removal procedures was used to measure the dentine samples. Microbiological procedures were based on experiments performed elsewhere 15 . The dentine samples were transferred to glass tubes containing 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature.…”

“…12,13,14 Clinical research comparing the conventional method (drilling) with the Carisolv ™ chemomechanical method has concluded that both methods are similar in terms of CFU reduction in residual dentine. 13,14,15,16 The purpose of the present study was to compare the efficacy of the chemochemical methods (Carisolv™ and Papacárie ® ) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth.…”