Journal of South Asian Association of Pediatric Dentistry

Register      Login

VOLUME 6 , ISSUE 3 ( September-December, 2023 ) > List of Articles

ORIGINAL RESEARCH

Clinical Efficacy and Pain Perception with Novel Chemomechanical Caries Removal Agent and Conventional Method in Primary Molars: A Randomized Controlled Study

Seema Bargale, Sejal Jain, Anshula N Deshpande, K S Poonacha, Saylee Deshmukh, Charmi Shah

Keywords : BRIX3000, Chemomechanical caries removal, Primary teeth

Citation Information : Bargale S, Jain S, Deshpande AN, Poonacha KS, Deshmukh S, Shah C. Clinical Efficacy and Pain Perception with Novel Chemomechanical Caries Removal Agent and Conventional Method in Primary Molars: A Randomized Controlled Study. J South Asian Assoc Pediatr Dent 2023; 6 (3):124-128.

DOI: 10.5005/jp-journals-10077-3282

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Conventional means of preparing cavities include the use of high-speed handpieces and slow-rotating instruments, following the philosophy of extension for prevention. This method usually induces pain, annoying sounds, and vibration. Thus, chemomechanical caries removal (CMCR) has been developed to be an alternative. It involves the application of proteolytic substances, which softens the carious dental tissue and facilitates its removal manually. BRIX3000 is a newer agent with upgraded properties that has been used for efficient caries removal. Aim: To evaluate and compare clinical efficacy and pain perception with a new CMCR agent (BRIX3000) and conventional caries removal method. Materials and methods: A total of 60 children aged between 4 and 9 years were allotted to the CMCR (BRIX3000) and rotary caries removal groups. Clinical efficacy and the Wong–Baker Pain Rating Scale (WBPRS) were used as the two parameters. The obtained data analysis was done using an independent t-test and Mann–Whitney U test. Results: Comparison of the difference in clinical efficacy showed a statistically significant difference in the CMCR (BRIX3000) group with a mean value of 2.33 ± 1.03 as compared to the rotary caries removal group with a mean value of 0.57 ± 0.68 with a p-value of <0.001. In WBPRS, the rotary caries removal group (mean: 4.6 ± 1.83) showed an increased score in comparison with the CMCR group (mean: 1.47 ± 1.17) with a p-value of <0.001. Conclusion: Chemomechanical caries removal (CMCR) group (BRIX3000) showed increased clinical efficacy as compared to rotary caries removal group. The rotary caries removal group showed increased WBPRS scores. Clinical significance: The use of the CMCR method in pediatric dentistry can prove to be very beneficial, especially in terms of anxiety and discomfort felt by the children.


HTML PDF Share
  1. Reddy MV, Shankar AJ, Pentakota VG, et al. Efficacy of antimicrobial property of two commercially available chemomechanical caries removal agents (Carisolv and Papacarie): an ex vivo study. J Int Soc Prev Community Dent 2015;5(3):183–189. DOI: 10.4103/2231-0762.159955
  2. Anusavice KJ, Kincheloe JE. Comparison of pain associated with mechanical and chemomechanical removal of caries. J Dent Res 1987;66(11):1680–1683. DOI: 10.1177/00220345870660111501
  3. Rajakumar S, Mungara J, Joseph E, et al. Evaluation of three different caries removal techniques in children: a comparative clinical study. J Clin Pediatr Dent 2013;38(1):23–26. DOI: 10.17796/jcpd.38.1.p3324121m66n1737
  4. Roberson M, Heymann O. Sturdevant's Art and Science of Operative Dentistry, 5th edition. St Louis: Mosby; 2006. pp. 308–311.
  5. Burke FJ, Crisp RJ, Hall AF. Patient's perception of treatment with Carisolv in general dental practice. J Dent Res 33:171–177.
  6. Bussadori SK, Guedes CC, Hermida Bruno ML, et al. Chemo-mechanical removal of caries in an adolescent patient using a papain gel: case report. J Clin Pediatr Dent 2008;32(3):177–180. DOI: 10.17796/jcpd.32.3.1168770338617085
  7. Subramaniam P, Gilhotra K. Antimicrobial efficacy of an indigenously prepared caries removing gel. Contemp Clin Dent 2011;2(1):13–16. DOI: 10.4103/0976-237X.79294
  8. Bussadori SK, Guedes CC, Bachiega JC, et al. Clinical and radiographic study of chemical-mechanical removal of caries using Papacarie: 24-month follow up. J Clin Pediatr Dent 2011;35(3):251–254. DOI: 10.17796/jcpd.35.3.75803m02524625h5
  9. Ismail MM, Haidar AH. Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city. J Baghdad Coll Dent 2019;31(2): 7–13. DOI: 10.26477/jbcd.v31i2.2617
  10. Torresi F, Besereni L. Effectiveness method of chemomechanical removal of dental caries as papain in adults. J Rev Assoc Paul Cir Dent 2017;71(3):266–269.
  11. Felizardo KR, de Alvarenga Barradas NP, Guedes GF, et al. Use of BRIX-3000 enzymatic gel in mechanical chemical removal of caries: clinical case report. J Health Sci 2018;20(2):87–93. DOI: 10.17921/2447-8938.2018v20n2p87-93
  12. Ericson D, Zimmerman M, Raber H, et al. Clinical evaluation of efficacy and safety of a new method for chemo-mechanical removal of caries. A multi-centre study. Caries Res 1999;33(3):171–177. DOI: 10.1159/000016513
  13. Kumar KVKS, Prasad MG, Sandeep RV, et al. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community-based setting: a comparative in vivo study. Eur J Dent 2016;10(3):386–391. DOI: 10.4103/1305-7456.184151
  14. Nadanovsky P, Cohen Carneiro F, Souza de Mello F. Removal of caries using only hand instruments: a comparison of mechanical and chemo-mechanical methods. Caries Res 2001;35(5):384–389. DOI: 10.1159/000047478
  15. Lager A, Thornqvist E, Ericson D. Cultivatable bacteria in dentine after caries excavation using rose-bur or carisolv. Caries Res 2003;37(3):206–211. DOI: 10.1159/000070446
  16. Mahdi M, Haidar AH. Evaluation of the efficacy of caries removal using papain gel (BRIX 3000) and smart preparation bur (in vivo comparative study). J Pharm Sci Res 2019;11(2):444–449.
  17. Nalawade HS, Lele GS, Walimbe HS. Comparative evaluation of efficacy of chemomechanical and conventional methods of caries excavation in young permanent molar teeth: in vivo study. J Dent Res 2019;6(1):13–18. DOI: 10.4103/jdrr.jdrr_71_18
  18. Gupta N, Chowdhary N, Reddy VR, et al. Evaluation of caries removal efficacy using BRIX 3000 and atraumatic restorative treatment in primary molars: a clinical comparative study. J Contemp Dent Pract 2022;23(4):419–424.
  19. Oommen SR, George L, Mathew J, et al. Assessment of pain response during caries removal using conventional tungsten carbide bur and a chemomechanical caries removal agent (Brix Gel): an in vivo study. JIDA 2021;15:21–27.
  20. Innes NP, Frencken JE, Bjørndal L, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res 2016;28(2):49–57. DOI: 10.1177/0022034516639276
  21. Abdul Khalek A, Elkateb MA, Abdel Aziz WE, et al. Effect of papacarie and alternative restorative treatment on pain reaction during caries removal among children: a randomized controlled clinical trial. J Clin Pediatr Dent 2017;41(3):219–224. DOI: 10.17796/1053-4628-41.3.219
  22. Pascareli-Carlos AM, Martins LF, Silva Gonçalves MD, et al. Pain perception of children after restorative treatments: atraumatic restorative treatment versus chemomechanical removal–a noninferiority randomized clinical trial. J Indian Soc Pedod Prevent Dent 2021;39(2):202–207. DOI: 10.4103/jisppd.jisppd_426_20
  23. Adham MM, El Kashlan MK, Abdelaziz WE, et al. The impact of minimally invasive restorative techniques on perception of dental pain among pregnant women: a randomized controlled clinical trial. BMC Oral Health 2021;21(1):1–9. DOI: 10.1186/s12903-021-01432-3
  24. Balachandran J, Raees T, Rao M, et al. Evaluation of efficacy of chemomechanical method of caries removal using BRIX- 3000 compared to conventional excavation with burs- a randomized controlled trial – original research. JIDA 2020;14;12–18. DOI: 10.33882/jida.14.25900
  25. Inamdar MS, Chole DG, Bakle SS, et al. Comparative evaluation of BRIX3000, CARIE CARE, and SMART BURS in caries excavation: an in vivo study. J Conserv Dent 2020;23(2):163–168. DOI: 10.4103/JCD.JCD_269_20
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.