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CLINICAL TRIAL article

Front. Oral. Health
Sec. Preventive Dentistry
Volume 5 - 2024 | doi: 10.3389/froh.2024.1458530
This article is part of the Research Topic Minimal Intervention Dentistry for Dental Caries Management View all 4 articles

Efficacy of Chemo-mechanical Caries Removal: A 24-month Randomized Trial

Provisionally accepted
Kemporn Kitsahawong Kemporn Kitsahawong 1Ana Lucia Seminario Ana Lucia Seminario 2Patimaporn Pungchanchaikul Patimaporn Pungchanchaikul 1Anoma Rattanacharoenthum Anoma Rattanacharoenthum 1Pipop Sutthiprapaporn Pipop Sutthiprapaporn 1Waranuch Pitiphat Waranuch Pitiphat 1*
  • 1 Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
  • 2 Timothy A. DeRouen Center for Global Oral Health, School of Dentistry, University of Washington, Seattle, United States

The final, formatted version of the article will be published soon.

    Introduction: Chemo-mechanical caries removal (CMCR) offers an alternative to conventional drilling for carious dentin removal, but limited evidence exists on its long-term effects on treating caries in primary teeth. The primary aims of this study were to compare CMCR to drilling in terms of restoration status and the presence of secondary caries after 24 months.Methods: A randomized, parallel-group, single-blinded, controlled trial was conducted in Thailand. Participants were children aged 7-8 years with occlusal caries in second primary molars, randomly assigned to CMCR with Papacarie® (n=242) or drilling (n=246). All cavities were restored using glass ionomer cement. Completeness of caries removal was evaluated clinically by two blinded dentists, and patients' discomfort was measured using a facial visual analogue scale. Restoration status and development of secondary caries were assessed every six months clinically and every 12 months radiographically over a 2-year period.Results: Both groups achieved complete caries removal, but the CMCR took significantly longer than the drilling method (9 versus 2.3 minutes, p<0.001). Children in the CMCR group reported significantly lower discomfort during treatment (p<0.001). At 24 months, ten (4.6%) restorations in the CMCR group failed, compared to three (1.2%) in the drilling group.Clinically, four restorations (CMCR=2, control=2) exhibited secondary caries at the margin, while nine restorations (CMCR=8, control=1) showed radiographic evidence of secondary caries beneath the restoration. However, neither clinical nor radiographic evaluations revealed statistically significant differences in treatment outcomes at the two-year mark.Conclusion: CMCR demonstrated comparable efficacy to conventional drilling for complete caries removal and restoration success at 24 months in primary teeth. Despite a longer chair time, it resulted in less discomfort during treatment.

    Keywords: Dental Caries, Dental Atraumatic Restorative Treatment, Papain, Glass Ionomer Cements, Deciduous tooth

    Received: 02 Jul 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Kitsahawong, Seminario, Pungchanchaikul, Rattanacharoenthum, Sutthiprapaporn and Pitiphat. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Waranuch Pitiphat, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand

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