Comparison between conventional and chemomechanical approaches for the removal of carious dentin: an in vitro study

Abstract

The present study aimed to evaluate the efficiency, effectiveness, and biocompatibility of two agents used for the chemomechanical removal of carious dentin. Sixty extracted carious human teeth were treated with a conventional bur (CBG) or chemomechanical agents - Papacarie Duo (PG) and Brix 3000 (BG). Treatment efficiency and effectiveness were assessed by the working time for carious dentin removal and Knoop microhardness values, respectively. Human pulp fibroblasts (FP6) were used to evaluate cytotoxicity by incorporating MTT dye, and genotoxicity was evaluated with the micronuclei test. The carious tissue was removed in a shorter time with CBG (median = 54.0 seconds) than the time required for chemomechanical agents (p = 0.0001). However, the time was shorter for Brix 3000 (BG) than that for Papacarie Duo (PG), showing mean values of 85.0 and 110.5 seconds, respectively. Regarding microhardness testing, all approaches tested were effective (p < 0.05). The final mean microhardness values were 48.54 ± 16.31 KHN, 43.23 ± 13.26 KHN, and 47.63 ± 22.40 KHN for PG, BG, and CBG, respectively. PG decreased cell viability compared to that of BG, but it presented no genotoxicity. Brix 3000 may be a good option for chemomechanical dentin caries removal due to its reduced removal time and lower cytotoxicity compared to the other treatment options.

Figure 1

Box plot illustrating the differences in time spent (in seconds) for carious tissue removal using different strategies. PPC = Papacarie Duo; BRI = Brix 3000; CBT = conventional bur treatment. Different letters represent statistically significant differences (Kruskal-Wallis test, p < 0.05). This figure has been published within the Master’s Thesis of the first author (T.M.L. Santos), which is available at the Federal University of Sergipe’s digital library of Theses and Dissertations: https://ri.ufs.br/handle/riufs/13164.

Figure 2

Percentage of cell viability relative to the mean of the control group in different dilutions of Papacarie Duo. Data are expressed as the mean ± the mean standard deviation. Different letters represent statistically significant differences among dilutions of the same material (ANOVA followed by Tukey’s test, p < 0.05). *Indicates a significant difference between the two materials at the same dilution. This figure has been adapted from the Master’s Thesis of the first author (T.M.L. Santos), which is available at the Federal University of Sergipe’s digital library of Theses and Dissertations: https://ri.ufs.br/handle/riufs/13164.

Figure 3

Percentage of cell viability relative to the mean of the control group in different dilutions of Brix 3000. Data are expressed as the mean ± the mean standard deviation. Different letters represent statistically significant differences among dilutions of the same material (ANOVA followed by Tukey’s test, p < 0.05). *Indicates a significant difference between the two materials at the same dilution. This figure has been adapted from the Master’s Thesis of the first author (T.M.L. Santos), which is available at the Federal University of Sergipe’s digital library of Theses and Dissertations: https://ri.ufs.br/handle/riufs/13164.