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Evaluation of chemomechanical caries removal using the Vickers hardness test: An in Vitro study

Published in Midentistry cc
Volume: 9
Issue: 2
Pages: 113 - 125

Objectives: Invasive caries removal should be kept to a minimum. Chemomechanical caries removal is one of several alternative methods to conventional caries excavation that have been used and involves the selective removal of soft carious dentin and preservation of the sound dentin. The purpose of this study is to determine whether complete caries removal is possible using this technique. The Vickers hardness of the dentin at the cavity floor following the in vitro removal of caries by the Carisolv™ chemomechanical caries removal system; and the effect of Carisolv™ gel and sodium hypochlorite 0.25% on the microhardness of sound dentin will be evaluated. Methods and Materials: The carious dentin of eighteen extracted human permanent molars was removed using Carisolv™ for one minute with instruments and excavation until the gel was clear. Caries removal was verified according to the color and hardness of the lesion. The Vickers Hardness Number (VHN) of the cavity floor was determined and the adjacent sound dentin for each tooth was used as a control reference. In addition, ten extracted caries-free teeth were sectioned from the occlusal third to expose the dentin. Adhesive tape was placed on the sectioned surface to separate the tested area from the control. Carisolv™ gel and sodium hypochlorite solution 0.25% were then applied on the sound dentin of the prepared teeth for three minutes (5 teeth for each material). After the removal of the adhesive tape, the VHN was measured for both tested and control areas. Results: The VHN of the cavity floor of the carious teeth was almost similar to that of the adjacent sound dentin, while the VHN of the sound dentin treated with sodium hypochlorite 0.25% was much lower than the VHN of the sound dentin treated with Carisolv™ gel. Discussion: The microhardness in this study indicated that Carisolv™ solution does not produce any adverse side effects on dentinal microhardness. Sodium hypochlorite randomly dissolved both demineralized and denatured dentin. The difference between the action of Carisolv™ containing sodium hypochlorite and the pure sodium hypochlorite solution could be explained by the amino acids added to Carisolv™. The amino acids might react with the sodium hypochlorite, thus reducing the organic tissue solving properties of the sodium hypochlorite in Carisolv™ gel. Conclusions: Carisolv™ gel does not cause a significant change in the microhardness of sound dentin and the treated carious dentin. In addition, the aminoacids present in the Carisolv™ gel play a role in the control of the sodium hypochlorite and minimize its aggressive effect on sound dentin. Clinical Significance: Optimum carious dentin removal by Carisolv™ is no longer difficult when the appropriate clinical procedure is followed. Therefore, cavity preparation with Carisolv™, provides a clean dentin surface without affecting the adjacent sound dentin and may also be favorable in clinical dentistry

About the journal
JournalJournal of Minimum Intervention in Dentistry
PublisherMidentistry cc
Open AccessNo