Chemo-Mechanical Caries Removal Techniques in Pediatric Dentistry

Chemo-mechanical caries removal (CMCR) represents a minimally invasive alternative to rotary instrumentation in the management of dentine caries in children. By combining selective chemical softening of infected dentine with gentle manual excavation, CMCR seeks to preserve healthy tooth structure, reduce the need for local anaesthesia and alleviate procedural discomfort. A variety of agents—ranging from proteolytic enzyme gels to aldehyde-based formulations—have been developed to target denatured collagen and facilitate removal of softened carious tissue. Contemporary research emphasises optimisation of working time, biocompatibility and antibacterial efficacy, while ensuring satisfactory mechanical properties of the residual dentine for durable restorations. The evolution of CMCR techniques has global significance, offering accessible, patient-friendly solutions in community and school dental programmes, particularly in settings where conventional rotary care is challenging.

Research from Nature Portfolio

In a comparative in vitro study, efficiency, effectiveness and biocompatibility of two enzyme-based gels were assessed alongside conventional bur excavation. Both agents achieved similar increases in dentine microhardness post-treatment, indicating thorough removal of softened carious tissue. One formulation demonstrated significantly lower cytotoxicity toward human pulp fibroblasts, while the other exhibited a reduction in removal time closer to that of the mechanical method. These findings support the clinical potential of optimised proteolytic gels for paediatric applications, balancing speed with tissue preservation and cell compatibility.

Chemo-Mechanical Caries Removal Techniques in Pediatric Dentistry publication trend

The graph below shows the total number of articles in chemo-mechanical caries removal techniques in pediatric dentistry across all publications each year (not limited to Nature Index journals).

Technical terms

Chemo-mechanical caries removal: A minimally invasive approach using chemical agents to soften infected dentine prior to manual excavation.

Proteolytic enzyme: A protein-digesting agent, often derived from plant sources, that degrades denatured collagen in carious dentine.

Knoop microhardness test: A measurement of dentine or enamel hardness determined by the size of an indentation made by a diamond indenter under a specific load.

References

1. Comparison between conventional and chemomechanical approaches for the removal of carious dentin: an in vitro study. Scientific Reports (2020).
2. Diagnosis and Assessment of Dental Caries Using Novel Bioactive Caries Detecting Dye Solution. Biomedicines (2023).
3. Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel. Journal of Applied Oral Science (2014).
4. Efficacy of antiseptics and chemomechanical methods for dentin caries lesions: A systematic review with GRADE approach. Frontiers in Oral Health (2023).