Key Points
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Chemochemical caries removal involves the selective removal of carious dentine. The reagent is prepared by mixing solutions of amino acids and sodium hydrochlorite.
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Reagents for the procedure were originally marketed as a solution known as Caridex. More recently, a similar system in the form of a gel has been marketed as Carisolv.
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Being a gel, Carisolv has the advantage of requiring volumes of less than 1 ml. No applicator system other than specially designed instruments is required.
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Because only carious dentine is removed, the painful removal of sound dentine is avoided and the need for local anaesthesia is minimised.
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The procedure is suitable for soft carious lesions access to which may still require conventional mechanical procedures.
Abstract
Chemomechanical caries removal involves the chemical softening of carious dentine followed by its removal by gentle excavation. The reagent involved is generated by mixing amino acids with sodium hypochlorite; N-monochloroamino acids are formed which selectively degrade demineralised collagen in carious dentine. The procedure requires 5–15 minutes but avoids the painful removal of sound dentine thereby reducing the need for local anaesthesia. It is well suited to the treatment of deciduous teeth, dental phobics and medically compromised patients. The dentine surface formed is highly irregular and well suited to bonding with composite resin or glass ionomer. When complete caries removal is achieved, the dentine remaining is sound and properly mineralised. The system was originally marketed in the USA in the 1980's as Caridex. Large volumes of solution and a special applicator system were required. A new system, Carisolv, has recently been launched on to the market. This comes as a gel, requires volumes of 0.2–1.0 ml and is accompanied by specially designed instruments.
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Beeley, J., Yip, H. & Stevenson, A. Chemochemical caries removal: a review of the techniques and latest developments. Br Dent J 188, 427–430 (2000). https://doi.org/10.1038/sj.bdj.4800501
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DOI: https://doi.org/10.1038/sj.bdj.4800501
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