Self-Limiting versus Rotary Subjective Carious Tissue Removal: A Randomized Controlled Clinical Trial—2-Year Results

Abstract

Background: the aim of this study was to assess the 2-year pulp survival of deep carious lesions in teeth excavated using a self-limiting protocol in a single-blind randomized controlled clinical trial. Methods: At baseline, 101 teeth with deep carious lesions in 86 patients were excavated randomly using self-limiting or control protocols. Standardized clinical examination and periapical radiographs of teeth were performed after 1- and 2-year follow-ups (REC 14/LO/0880). Results: During the 2-year period of the study, 24 teeth failed (16 and 8 at T12 and T24, respectively). Final analysis shows that 39/63 (61.9%) of teeth were deemed successful (16/33 (48.4%) and 23/30 (76.6%) in the control and experimental groups, respectively with a statistically significant difference (z score = 2.3, p = 0.021). Of teeth with severe and mild symptoms at T0, 42.9% and 36.7% respectively failed at T24 (p > 0.05). Within the self-limiting group, there was a lower success in premolars compared to molars (p < 0.05). Conclusion: after 2 years, there was a statistically significant higher pulp survival rate of teeth with deep carious lesions excavated using self-limiting protocols in patients with reversible pulpitis. Molars showed higher success than premolars in teeth excavated using the self-limiting protocol. There was no statistically significant association between the outcome and the severity of symptoms at T0 (ClinicalTrials.gov NCT03071588).

Clinical and Radiographic Evaluation of 2.25% Sodium hypochlorite gel and Brix 3000 in caries removing of deciduous teeth.

“…The current study reported 91.7% success rate in 2.25% sodium hypochlorite gel group after six months of evaluation. This result was compatible with Ali et al, 2020 (20) study that reported 76.6% success rate in badly decayed permanent teeth treated with carisolv (NaOCl based chemomechanical caries removing agent) after 2 years follow up.…”

“…While on regard to caries removal time the conventional group came first then Brix 3000 group followed by 2.25% sodium hypochlorite gel group with highly significant differences between groups. Generally, these results in agreement with Alkhouli et al, 2020 (6) , Santos et al, 2020 (8) , Dogra et al, 2021 (16) , Cardoso et al, 2020 (17) , Peric et al, 2009 (18) , Bussadori et al, 2014 (19) and Ali et al, 2020 (20) CONCLUSION 1. Both 2.25% sodium hypochlorite gel and Brix 3000 were effective in dental caries removing and should be considered effective chemomechanical dental caries removing agents.…”

Effect of a novel coating material on the microleakage of glass hybrid restoration in primary teeth – An in vitro study

“…A single, well-trained operator prepared all the samples. After establishing appropriate access to the carious cavitation by removing carious and undermined enamel using a diamond bur (Henry Schein, USA) (14) , cavities were prepared by ceramic bur (CeraBur, Komet, Germany) mounted on slow speed hand-piece to remove carious tissue selectively. Then cavities were washed with water spray, air dried, and a suitable matrix band was applied, preparing them for the restorative procedure.…”

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

“…Group 3 (blue) focused on different aspects related to chemo-mechanical caries removal methods, especially those that involved the use of Carisolv [2,4,5,16,24,30,31,[33][34][35][36][41][42][43]46,[49][50][51]54,55,57,59,60,[63][64][65][66][67][68][69]. Similarly to the first group, the articles included in this group also studied different adhesive systems and the microtensile bond strength or the microleakage of the interface between the residual dentin and composite resin [27,[32][33][34][35][36]47] or glass ionomer cement [19,36,64,68].…”

“…Group 4 (yellow) focused on the clinical aspects of using CMCR methods on deciduous teeth [4,5,35,38,42,45,46,54,57,59,69,70], mainly on the pain management in pediatric patients [4,5,38,44,48,66,[70][71][72] and on the efficacy of CMCR methods when compared to rotary instruments [4,37,47,54,63,66].…”