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Abstract

Objective: There are many different methods for removing caries. In this study, to evaluate four caries removal methods in terms of patient comfort and to evaluate the clinical success of restorations according to modified-USPHS criteria. Methods: In 31 patients with at least 4 Class II caries in their posterior teeth, 4 teeth were randomly divided into four groups and 4 different methods (conventional method, Carisolv, Papacarie, Er-Cr:YSGG Laser) were used for caries removal. Pain formation during caries removal was determined by FACE Pain Scale questionnaire. The restorations were controlled with Modified-USPHS criteria in 3-6-12 months period. Mann-Whitney U test for two-group comparisons, Kruskal Wallis H test for comparison of three or more groups, Wilcoxon Sign test was used to examine the changes according to time (p < 0.05). Results: A significant difference was found between conventional methods and alternative methods in terms of pain tolerance. In the 1-year clinical evaluation of the restorations, there was a significant decrease in the postoperative sensitivity in all groups. A significant difference was detected in Carisolv and laser groups between 6-months and 12-months for marginal coloration. A significant difference was found between the conventional and laser groups between 6-months and 12-months in terms of color match. Conclusion: The success of restorations, efficacy and efficiency of the methods used in the evaluation of all groups were found to be successful. In terms of patient comfort, all alternative methods gave positive results.

References

  1. Yamada Y, Hossain M, Nakamura Y, Suzuki N, Matsumoto K. Removal of carious dentin by mechanical, chemomechanical and Er: YAG laser in deciduous teeth. J Oral Laser Appl. 2001; 1(2):109-14.

  2. Fusayama T. New concepts in operative dentistry: Differentiating two layers of carious denitin and using an adhesive resin. Illinois: Quintessence Publishing Company; 1980.

  3. Dammaschke T, Stratmann U, Mokrys K, Kaup M, Reiner Ott KH. Reaction of sound and demineralised dentine to Carisolv in vivo and in vitro. J Dent. 2002; 30(1):59-65.

  4. Banerjee A, Kidd EA, Watson TF. In vitro evaluation of five alternative methods of carious dentine excavation. Caries Res. 2000; 34(2):144- 50.

  5. Banerjee A, Watson TF, Kidd EA. Dentine caries excavation: a review of current clinical techniques. Br Dent J. 2000; 188(9):476-82.

  6. Gupta S, Singh C, Yeluri R, Chaudhry K, Munshi AK. Clinical and microbiological evaluation of the carious dentin before and after application of Papacarie gel. J Clin Pediatr Dent. 2013; 38(2):133- 8.

  7. Hossain M, Nakamura Y, Yamada Y, Murakami Y, Matsumoto K. Microleakage of composite resin restoration in cavities prepared by Er,Cr:YSGG laser irradiation and etched bur cavities in primary teeth. J Clin Pediatr Dent. 2002; 26(3):263-8.

  8. Ramos AC, Esteves-Oliveira M, Arana-Chavez VE, de Paula Eduardo C. Adhesives bonded to erbium:yttrium-aluminum-garnet laser-irradiated dentin: Transmission electron microscopy, scanning electron microscopy and tensile bond strength analyses. Lasers Med Sci. 2010; 25(2):181- 9.

  9. Schoop U, Kluger W, Moritz A, Nedjelik N, Georgopoulos A, Sperr W. Bactericidal effect of different laser systems in the deep layers of dentin. Lasers Surg Med. 2004; 35(2):111-6.

  10. Senthilkumar V, Ramesh S. Systematic review on alternative methods for caries removal in permanent teeth. J Conserv Dent. 2020; 23(1):2-9.

  11. de Almeida Neves A, Coutinho E, Cardoso MV, Lambrechts P, Van Meerbeek B. Current concepts and techniques for caries excavation and adhesion to residual dentin. J Adhes Dent. 2011; 13(1):7-22.

  12. Lussi A, Megert B, Longbottom C, Reich E, Francescut P. Clinical performance of a laser fluorescence device for detection of occlusal caries lesions. Eur J Oral Sci. 2001; 109(1):14-9.

  13. Schmalz G, Ryge G. Reprint of Criteria for the clinical evaluation of dental restorative materials. Clin Oral Investig. 2005; 9(4):215-32.

  14. Yamada Y, Hossain M, Suzuki N, Kinoshita JI, Nakamura Y, Matsumoto K. Removal of carious dentin by Er:YAG laser irradiation with and without carisolv. J Clin Laser Med Surg. 2001; 19(3):127-31.

  15. Anusavice KJ, Kincheloe JE. Comparison of pain associated with mechanical and chemomechanical removal of caries. J Dent Res. 1987; 66(11):1680-3.

  16. Motta LJ, Bussadori SK, Campanelli AP, da Silva AL, Alfaya TA, de Godoy CH, Navarro MF. Pain during removal of carious lesions in children: A randomized controlled clinical trial. Int J Dent. 2013; 2013:896381.

  17. Braun A, Graefen O, Frentzen M, Nolden R. Objektiv darstellbare Empfindungen am Zahn während der Einwirkung von Carisolv. Quintessenz J. 2000; 51(5):461-9.

  18. Korkut E, Gezgin O, Özer H, Şener Y. Evaluation of Er: YAG lasers on pain perception in pediatric patients during caries removal: a split-mouth study. Acta Odontol Turc. 2018; 35(3):81-6.

  19. Jacboson B, Berger J, Kravitz R, Ko J. Laser pediatric Class II composites utilizing no anesthesia. J Clin Pediatr Dent. 2004; 28(2):99-101.

  20. Inoue H, Izumi T, Ishikawa H, Watanabe K. Shortterm histomorphological effects of Er:YAG laser irradiation to rat coronal dentin-pulp complex. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97(2):246-50.

  21. Yazici AR, Atílla P, Ozgünaltay G, Müftüoglu S. In vitro comparison of the efficacy of Carisolv and conventional rotary instrument in caries removal. J Oral Rehabil. 2003; 30(12):1177-82.

  22. Piva E, Ogliari FA, Moraes RR, Corá F, Henn S, Correr-Sobrinho L. Papain-based gel for biochemical caries removal: Inf luence on microtensile bond strength to dentin. Braz Oral Res. 2008; 22(4):364-70.

  23. Arora R, Goswami M, Chaudhary S, Chaitra TR, Kishor A, Rallan M. Comparative evaluation of effects of chemo-mechanical and conventional caries removal on dentinal morphology and its bonding characteristics - An SEM study. Eur Arch Paediatr Dent. 2012; 13(4):179-84.

  24. Hosoya Y, Kawashita Y, Marshall GW Jr, Goto G. Influence of Carisolv for resin adhesion to sound human primary dentin and young permanent dentin. J Dent. 2001; 29(3):163-71.

  25. Hosoya Y, Shinkawa H, Marshall GW. Influence of Carisolv on resin adhesion for two different adhesive systems to sound human primary dentin and young permanent dentin. J Dent. 2005; 33(4):283-91.

  26. Tachibana A, Marques MM, Soler JM, Matos AB. Erbium, chromium:yttrium scandium gallium garnet laser for caries removal: Influence on bonding of a self-etching adhesive system. Lasers Med Sci. 2008; 23(4):435-41.

  27. Yoshida Y, Nagakane K, Fukuda R, Nakayama Y, Okazaki M, Shintani H, Inoue S, Tagawa Y, Suzuki K, De Munck J, Van Meerbeek B. Comparative study on adhesive performance of functional monomers. J Dent Res. 2004; 83(6):454-8.

  28. Pazinatto FB, Gionordoli Neto R, Wang L, Mondelli J, Mondelli RF, Navarro MF. 56-month clinical performance of Class I and II resin composite restorations. J Appl Oral Sci. 2012; 20(3):323-8.

  29. Ergücü Z, Türkün LS. Clinical performance of novel resin composites in posterior teeth: 18-month results. J Adhes Dent. 2007; 9(2):209-16. Erratum in: J Adhes Dent. 2007; 9(3):340.

  30. Kusumasari C, Abdou A, Nakajima M, Tagami J. Deproteinization of caries-affected dentin with chemo-mechanical caries removal agents and its effect on dentin bonding with self-etch adhesives.J Dent. 2021; 109:103665.

  31. Kusumasari C, Abdou A, Tichy A, Hatayama T, Hosaka K, Foxton RM, Wada T, Sumi Y, Nakajima M, Tagami J. Effect of smear layer deproteinization with chemo-mechanical caries removal agents on sealing performances of self-etch adhesives. J Dent. 2020; 94:103300.

  32. Gama-Teixeira A, Simionato MR, Elian SN, Sobral MA, Luz MA. Streptococcus mutans-induced secondary caries adjacent to glass ionomer cement, composite resin and amalgam restorations in vitro. Braz Oral Res. 2007; 21(4):368-74.

  33. Y Yazici AR, Baseren M, Gorucu J. Clinical comparison of bur- and laser-prepared minimally invasive occlusal resin composite restorations: Two-year follow-up. Oper Dent. 2010; 35(5):500-7.

  34. Yousaf A, Aman N, Manzoor MA, Shah JA, Dilrasheed. Postoperative sensitivity of self etch versus total etch adhesive. J Coll Physicians Surg Pak. 2014; 24(6):383-6.

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