Chemomechanical Caries Removal For Caries Treatment:a Systematic Review

Objective:To compare the effectiveness and investigate the clinic value between chemomechanical and mechnical caries removal for caries.Methods:PubMed, Cochrane Library, EMBASE, Chinese Biomedical Literature Database, China Journal Full-text Database, Chinese Scientific Journals Full-text Database, WanFang Database. We also traced back the references to collect the relevant trails. According to the Cochrane Handbook for systematic reviews of interventions5.0. Statistic analyses were calculated using Revman5.0software.Results:Twenty-two studies were involved and2757patients were included. The results of meta-analysis are as follows:To compare chemomechanical with mechanical caries removal, there was no statistically significant difference in complete caries removal[OR=0.52,95%CI (0.25,1.07),P=0.08]、pulp exposure [OR=0.18,95%CI (0.03,1.11),P=0.06]、secondary caries[OR=0.86,95%CI (0.53,1.42), P=0.56]、lost or fractured filling[OR=1.06,95%CI (0.55,2.02), P=0.87]; To compared with mechanical caries removal, chemomechanical caries removal could increases1-year success [OR=1.81,95%CI(1.28,2.55), P=0.0008], decreases the dental anxiety[OR=0.25,95%CI (0.09,0.64), P=0.004] and pulp complications[OR=0.09,95%CI(0.03,0.27), P<0.0001] and reduce the use of anesthesia[OR=0.13,95%CI(0.07,0.24), P<0.00001]. But the time of chemomechanical group longer than mechanical group.[caries removal time1-10min:OR=0.03,95%CI (0.01,0.11), P<0.00001; caries removal time11-15min:OR=24.46,95%CI (6.25,95.77), P<0.00001; caries removal time>15min: OR=6.05,95%CI (1.13,32.47),P=0.04].Conclusion Chemomechanical caries removal can achieve the effect of mechanical caries removal, it also can improve1-year success、decrease the dental anxiety and reduce the use of anesthesia. Currently available evidence suggests chemomechanical caries removal is an effective and minimally invasive method for caries treatment.