Comparison of the efficacy of chemomechanical caries removal (Carisolv) with that of conventional excavation in reducing the cariogenic flora

Abstract

Objectives: The usage of minimally invasive procedures and attention to patient comfort are of great importance, especially for dental treatment in small children. This has led to the development of chemomechanical methods for caries removal. The aim of this study was to compare the efficacy of chemomechanical caries removal with that of conventional excavation in reducing the count of the cariogenic flora.

Design and setting: Subjects for this study were chosen from children admitted to dental clinic for restorative procedures under general anaesthesia.

Samples and methods: Twenty-one children (mean age 43.5 +/- 12.0 months) with early childhood caries were included in this study. Two primary teeth with comparable degrees of carious destruction were chosen in each child (n = 42) for caries removal with Carisolv' or by means of rotary instruments. Samples from carious dentine were taken with a sterile scraping instrument, then all softened dentine was removed and a second sample was taken. All samples (n = 84) were serially diluted and plated on two different nutrient agar plates.

Results: After 24 h of incubation, colony forming units were determined for total bacterial counts and lactobacilli. Twelve per cent of the samples from carious dentine contained more than 10(6) bacteria, 23.8% contained more than 10(5) lactobacilli. Both methods of caries removal produced a statistically significant reduction in the bacterial counts (P = 0.0001). In at least 90.5% of the samples taken after the removal, the total bacterial count was below 10(2), and in 95.2% lactobacilli fell below 10(2).

Conclusion: These results indicate that the efficacy of chemomechanical removal of carious dentine in children by means of Carisolv' is comparable to the results obtained by conventional methods, and thus might serve as a suitable alternative.