Search Results (10)

The study investigated the effectiveness of a babaco-based gel derived from an endemic Ecuadorian fruit for chemomechanical caries removal compared to the conventional non-rotary mechanical method. Babaco contains proteolytic enzymes that soften decayed dental tissue, making it a potential alternative for caries treatment. An ex vivo experimental study was carried out using sixty extracted human teeth, each divided into two sections: one treated with babaco gel and the other with a spoon excavator. Four extraction methods (maceration, distillation, Soxhlet, and percolation) were used to prepare the gel. After rehydration and submersion in nitric acid, an oral pathologist evaluated the efficacy of caries removal. Results showed a 78% success rate for the babaco-treated sections, significantly higher than the 14% success rate for the conventional method. The distillation-extracted gel subgroup performed best at p < 0.01 Fisher Chi². The study concluded that babaco gel is more effective for caries removal than traditional methods, highlighting its potential as a chemical-mechanical alternative. Full article

Background/Objectives: The objective of this review is to establish a solid base of information regarding the use of proteolytic enzymes to replace hydrogen peroxide/carbamide in teeth whitening products. The use of proteolytic enzymes, such as bromelain and papain, can provide surprising results for solving two important aspects related to dental aesthetics: tooth whitening and the chemo-mechanical removal of damaged dental tissue. Due to their ability to degrade salivary proteins, these enzymes can be used successfully as active agents in tooth whitening and in the atraumatic treatment of caries without being accompanied by other side effects on dental components. Methods: Random-effects meta-analyses were performed with enzymes (bromelain, papain) used in dentistry. A keyword search of scientific publications was conducted using the Google Academic, Web of Science and PubMed search engines. Results: The results were systematized in the present work in two parts: bromelain and papain effects in tooth whitening and chemo-mechanical/atraumatic removal of damaged dental tissues. Conclusions: The findings from different studies and clinical reports indicate that bromelain and papain could be considered efficient and safe therapeutic agents not only in various medical conditions but also in dental problems. Full article

Background: Dental caries is the most common oral disease in the world. When treatable, the drilling method continues to be used. This technique has its disadvantages because it is invasive and nonspecific. Chemomechanical carious tissue removal agents (CCRAs) such as Carisolv™ or Papacarie^® are non-invasive products that allow for the specific elimination of infected dentin. On the other hand, cariogenic bacteria are largely responsible for the initiation and development of lesions. Objectives: The aim is to analyze whether CCRAs have a relevant antimicrobial effect on cariogenic bacteria. Methods: A bibliographic search strategy was carried out in online databases using PRISMA 2020. The evaluation of the antibacterial efficacy of CCRAs was carried out through the analysis of the reduction in CFUs of cariogenic bacteria, and the presence of bacterial deposits, TVC, SVC and LVC by comparison with conventional drilling methods. Results: The results showed that the percentage of reduction in TVC, SVC and LVC for each agent is mostly high, but not significantly different from mechanical methods. The best results were found with CCRAs when compared to polymeric drills. The results also showed that there is a lack of methodological standardization. Conclusions: CCRAs have been shown to have a relevant antimicrobial effect on cariogenic bacteria; however, more studies need to be carried out using standardized methodologies. Full article

Although there are several studies that have evaluated the bond strength of various adhesives to healthy dentin and caries-affected dentin after traditional caries removal, the objective of this systematic review aimed to assess the bond strength of various adhesives to caries-affected dentin (CAD) after chemo-mechanical caries removal (CMCR) treatment. The review adhered to PROSPERO protocol registration and followed PRISMA guidelines. The research question focused on the bonding effectiveness of dental adhesives to CAD after employing the chemo-mechanical caries removal method. PubMed, the TRIP database, and Scopus were searched, with the last search conducted in February 2023. Two reviewers independently screened and evaluated articles, resulting in 30 articles for full-text analysis out of 434 retrieved from databases. Twelve eligible studies were included in the review. The bond strength of etch-and-rinse (ER) and self-etch (SE) adhesive systems was assessed following CMCR treatment on CAD. SE adhesive systems exhibited higher bond strength to CAD compared to ER adhesive systems. Meta-analysis indicated that the bond strength achieved with self-etching adhesive systems remained consistent, regardless of the CMCR agent (Carisolv or Papacarie) used on dentin. The findings of this systematic review suggest that self-etch adhesive systems show favorable bond strength to caries-affected dentin following chemo-mechanical caries removal, regardless of the specific CMCR agent used. These results support the use of minimally invasive dentistry techniques aimed at preserving healthy tooth structure, dentin in particular. Full article

Background: The goal of materials should be early caries detection, removal of carious lesions, and reduction of dentin hypersensitivity. Thus, the study aims to determine the efficacy of a bioactive caries detecting dye (BCD) for the diagnosing and mechanical removal of occlusal and proximal dental caries. Methods: Patients with occlusal (A1, A2) and proximal carious lesions (B1, B2) were treated with the rotary technique and BCD solution on 120 teeth (n = 60 for each). Group 1: Excavation was performed using diamond points. Group 2: 0.5 mL of BCD solution was scrubbed for 20 sec and excavation was performed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required, VAS for pain, VAS for facial expression, and sound eye motor scoring were scored during excavation. Post-restoration evaluation was performed at 3, 6, and 12 months (FDI criteria). Results: The chi-square test revealed that the A1 (197.90 30.97 s) and B1 (273.06 69.95 s) had significantly less mean procedural time than the A2 (292.13 44.87 s) and B2 (411.86 88.34 s). BCD (A2, B2) group showed good patient acceptance, less pain during caries excavation VAS (p = 0.001, FACE (p = 0.001), and SEM (p < 0.001) analysis than the rotary group. There was a statistically insignificant difference between groups immediately (p = 0.235), (p = 0.475) and after 24 h (p = 0.561), (p = 0.688). Color score, hardness of excavated surface, and caries removal score for occlusal and proximal groups showed insignificant differences between the groups. BCD group showed significantly less mean caries excavated volume for the occlusal group (p = 0.003) as compared to the proximal group (p = 0.417) evaluated by 3D scanner. Evaluation of restoration after 3-, 6-, and 12 months intervals (Occlusal caries group (p = 0.247), (p = 0.330), and (0.489) and Proximal caries group (p = 0.299), (p = 0.594), and (0.494)) was acceptable for both the groups. Conclusion: BCD helps in identification of dental caries clinically, radiographically, and in effective removal of denatured teeth with less pain or sensitivity. Full article

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. Full article

Background: From one year to another, dentists have access to more procedures using modern techniques. Many of them can improve the effectiveness of dental procedures and frequently facilitate and accelerate them. Objectives: Technically advanced devices are an important part of modern dentistry. Over the years, there were developed technologies like ultrasounds, lasers, air abrasion, ozonotherapy, caries diagnostic methods, chemomechanical caries removal (CMCR), pulp vitality tests, computer-controlled local anesthetic delivery (CCLAD). The aim of this study was to investigate the requirement of Polish dentists for such technologies. Methods: An anonymous questionnaire was posted on a social media group of dentists from Poland. 187 responses were obtained. Results: It turned out that almost every respondent uses ultrasounds, but other technologies are not as popular. 43% use CCLAD, 33% use diagnostic methods, 28% use air abrasion, 25% use dental lasers, 21% use CMCR, 18% use pulp vitality tests and 6% use ozonotherapy. The most common reason for not using the aforementioned technologies were their high cost and the sufficient effectiveness of raditional methods. There was a correlation between use of a dental laser and CCLAD and size of office, CMCR use and dentists’ work time and air abrasion use and gender. Many dentists claim that they will try one of the modern technologies in the future. Conclusions: It can be concluded that Polish dentists tend to use ultrasounds and CCLAD more than any other technology. In the future this may change, so more studies in this topic are needed. Full article

In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application. Full article

Dental caries is a disease of dental hard tissues, considered the most common non-communicable disease worldwide. Conventional treatments for caries removal are often associated with pain and fear, so different therapeutic approaches have been developed towards more conservative and pleasant treatments. This systematic review aimed to assess the efficacy and patient’s acceptance of alternative methods for caries removal compared to conventional methods. The Cochrane Library, Embase, Medline/Pubmed, Web of Science, and Clinical Trials databases were searched. Clinical trials of primary dental caries treated with alternative methods were included. The last search was performed on 5 August 2020. The Population, Intervention, Comparison, and Outcome (PICO) strategy was followed. Thirty-seven clinical trials were included, reporting caries removal using alternative (chemomechanical—Brix 3000, Carie-care, Carisolv and Papacarie, laser—Er:YAG (Erbium-doped Yttrium Aluminium Garnet) and Er,Cr:YSGG (Erbium, Chromium-doped Yttrium, Scandium, Gallium and Garnet), and a system combining air and sono-abrasion—Vector^® System) and conventional methods. Alternative methods tended to prolong treatment time and lessen anesthesia need. All treatments were effective in reducing cariogenic flora, and the restoration’s performance did not differ significantly. Chemomechanical solutions seemed to be the best option towards minimally invasive treatments, with good control during application and action and good treatment experiences for patients. Papacarie was demonstrated to be an effective method for caries removal with less pain, and superior acceptance by patients when compared to conventional treatments. Full article

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). Full article