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

Abstract

The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 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. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.

Effects of Papacarie on children with dental caries in primary teeth: a systematic review and meta‐analysis

“…The type, generation, and dose of the medicine are different. Among the included studies, five trials discussed the change in bacteria in the caries lesion, and two trials were excluded in the meta‐analysis for a lack of mean and SD data. In addition, 10 trials assessed the outcomes of pain perception before and after different caries removal methods; nevertheless, the scales used in these trials differ considerably.…”

Efficacy and Patient’s Acceptance of Alternative Methods for Caries Removal—A Systematic Review

“…Until today, different therapeutic approaches regarding dental cavities have been discussed and reconsidered in order to be as conservative as possible and to preserve tooth structure by only removing the irreversibly damaged dental tissues [ 12 , 13 , 15 , 16 ]. This leads to increased tooth longevity and prevents the repetitive restorative cycle [ 12 , 15 ].…”

Antibacterial Activity of Two Chemomechanical Caries Removal Gels on Carious Dentin of Primary Teeth: An in vitro Study

“…Chemomechanical caries removal combines atraumatic characteristic with bactericidal and bacteriostatic actions. 21 Results of a CMCR study for children show that chemomechanical treatment of carious dentin could be as effective as traditional caries removal technique, causes less pain, and lowers the need for local anesthesia. 22 Current literature reports that Carisolv is the most commonly used chemomechanical product to remove dental caries.…”