Influence Of Carisolv On Resin Adhesion And Evaluation Of Its Clinical Application

Asa common and frequent-occuring disease, dental caries management is very important. The development of adhesive dentistry and scientific progress in understanding the nature of caries has enabled dentists to preserve more healthy set of natural structure for each tooth. The Carisolv chemomechanical caries removal method is such a minimally invasive method, which can soften the carious dentin by chemical agents and. only remove the infected carious dentin with the specially designed instruments. In our research, we evaluate the morphology of dentin surface, microtensile bond strengths, nanoleakage and clinical application with use of Carisolv, which help us carry out its clinical therapy successfully.Part One Experimental Research1 Scanning Electron Microscope Study of Permanent Dentine Surface after Carisolv Chemomechanieal Caries RemovalMaterials and Methods: 10 decayed permanent molars were collected.Carisolv system(the test group) was compared with slow-speed bur(the control group) in eliminating caries. Then surfaces were observed using the scanning electron microscope.Results: Less debris and smear layer were observed in Carisolv system than slow-speed bur. The differences were statistically significant(P<0.05).Conclusions: The dentine surface with morphological changes after elimination of caries by Carisolv system was especially suitable for adhesion of composite resin.2 Influence of Carisolv on Resin Adhesion to Permanent DentinMaterials and Methods: 12 caries-free extracted human molars were used to tested the microtensile bond strengths(mTBS) of normal dentin(ND) to resin, while 12 extracted human molars with occlusal carious lesions extending into mid-dentine were used to tested the mTBS of caries-affected dentin(CAD) to resin. Each group was randomly subdivided into Carisolv chemomechanical group and bur mechanical group. Their occlusal enamel was removed in order to expose a fiat dentinal surface. After treated with Carisolv or bur, the occlusal cavities in each group were restored with Adper Prompt bonding system plus 3M Z100 composite. All the teeth were sectioned to obtain matchstick-shaped specimens with bonded surface area about 0.9mm×0.9mm. The mTBS was tested in a microtensile tester. Scanning electron microscopy(SEM) was used to ascertain the mode of failure at the restoration-dentine interface.Results: The mTBS(MPa) of Carisolve to CAD and ND were 22.98±4.17 and 26.26±4.13, that of slow-speed bur 20.01±3.97 and 26.78±4.18, respectively. There was statistical significane between Carisolve and bur to CAD, but no statistical significane between Carisolve and bur to ND.Conclusions: Carisolve treatment significantly increased resin adhesion to CAD, but did not influence resin adhesion to ND.3 Influence of Nanoleakage on Dentin Adhesive Bonded to Carisolv-treated DentinMaterials and Methods: Twenty extracted human molars with carious lesions extending into mid-dentine were selected, which were randomly divided into Carisolv chemomechanical group and bur mechanical group. Flat occlusal dentin surfaces, including carious lesions, were prepared from extracted human molars. After carious dentin were removed with Carisolv or slow-speed bur, the excavated dentin surfaces in each experimental group were restored with Adper Prompt bonding system plus 3M Z100 composite. The bonded interfaces were polished and the surrounding tooth surfaces were coated with nail varnish. Specimens were immersed into 50%(w/v) silver nitrate solution for 24 hours, exposed to photo developing solution for 8 hours, then sectioned longitudinally through the bonded, excavated dentin. The sectioned surfaces were polished, carbon coated and observed in SEM using back scattered electrons. Tukey's test were used for statistical analysis of the nanoleakage scores.Results: The nanoleakage scores of Carisolv chemomechanical group and bur mechanical group were 24.31%±9.63% and 27.69%±9.90%, respectively.Conclusions: Carisolv did not affect the nanoleakage of dentin to bond adhesive.Part Two Clinical Research Clinical Evaluation of Carisolv Chemomeehanical Caries RemovalMaterials and Methods: 100 permanent teeth of dental caries were randomly divided into two groups with 50 each. Experiment group were treated with Carisolv. Control group were treated with slow-speed bur. After caries removed, working time and degree of pain during the treatment were recorded for both methods. Then cavities were. restored with Adper Prompt bonding system plus 3M composite. The evaluation of restorations at 1 week and 6 months were used by modified USPHS.Results: The time spent for the removal of caries with Carisolv and with slow-speed bur was 6.17 min±1.92 min and 2.83 min±0.93 min, respectively (P＜0.05). The degree of pain with Carisolv was significantly low(P＜0.05). No statistically significant difference among two groups was observed for evaluated categories at test period at 1 week and 6 months(P＞0.05).Conclusions: Carisolv chemomechanical caries removal was an alternative method of caries treatment.