title: Efficacy of chemomechanical caries removal in reducing cariogenic microbiota: a randomized clinical trial.
abstract: The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.
authors.affiliation: Department of Specific Training, School of Dentistry, Universidade Federal Fluminense, Nova Friburgo, RJ, Brazil.
authors.forename: Michelle Mikhael
authors.initials: MM
authors.lastname: Ammari
authors.affiliation: Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz Flávio Martins
authors.initials: LF
authors.lastname: Moliterno
authors.affiliation: Department of Microbiology, Immunology and Parasitology, School of Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Raphael
authors.initials: R
authors.lastname: Hirata Júnior
authors.affiliation: School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Mariana Canano
authors.initials: MC
authors.lastname: Séllos
authors.affiliation: Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Vera Mendes
authors.initials: VM
authors.lastname: Soviero
authors.affiliation: Department of Microbiology, School of Dentistry, Centro Universitário Serra dos Órgãos, Teresópolis, RJ, Brazil.
authors.forename: Wagner Pereira
authors.initials: WP
authors.lastname: Coutinho Filho
mesh_terms: D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003731:Dental Caries / Q000382:microbiology* / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000379:methods*; D003804:Dentin / Q000187:drug effects / Q000382:microbiology; D005260:Female; D018698:Glutamic Acid / Q000627:therapeutic use*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D007930:Leucine / Q000627:therapeutic use*; D008239:Lysine / Q000627:therapeutic use*; D008297:Male; D010206:Papain / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: C119934:Carisolv; C509557:Papacarie; D018698:Glutamic Acid; D010206:Papain; D007930:Leucine; D008239:Lysine