Clinical randomized controlled trial of chemomechanical caries removal (Carisolv™)

Objectives. The purpose of this study was to compare the chemomechanical caries-removal system (Carisolv(TM)) with high-speed excavation in cavitated occlusal caries of primary molars. Design and setting. The study was a randomized controlled, clinical trial in which the two techniques were compared in each subject. Participants were chosen from public schools, in Maracaibo County, Zutia State, Venezuela. Sample and methods. The sample consisted of 80 primary molars selected from 40 children (mean age 7.7 +/- 0.7 years). Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions. The outcome variables were: clinically complete caries removal, size of the opening of the cavity, volume of carious tissue removed, pain during caries removal, anaesthesia requested by the patient, caries-removal time, and behaviour and preference of patients. Results. All treated molars were clinically caries free whichever caries-removal procedure was used. When Carisolv(TM) was used the final cavity entrance sizes were smaller (P < 0.001) and the estimated volume of tissue removed was less (P < 0.001). The time taken for caries removal was three times longer (7.51 +/- 1.83 min, P < 0.001). Some pain was reported by seven (17.5%) participants when Carisolv was used, compared with 16 (40%) when high-speed excavation was used (P < 0.05). Using the Carisolv method there was a higher proportion of patients with positive behaviour (P < 0.01), and 71.0% (P < 0.05) preferred this treatment. Conclusion. Carisolv is an effective clinical alternative treatment for the removal of occlusal dentinal caries in cavitated primary molars; it is more conservative of dental tissue and appeared to be more comfortable for most patients, although the clinical time spent is longer than when using high-speed excavation.