title: Comparison of Carisolv system vs traditional rotating instruments for caries removal in the primary dentition: A systematic review and meta-analysis.
abstract: OBJECTIVE
  The purpose of this systematic review and meta-analysis was to evaluate the reliability of the Carisolv system with respect to drilling regarding the full removal of decayed hard tissues in primary dentition. A systematic review of the literature was conducted to identify controlled trails, randomized controlled trials and clinical trials that compared the Carisolv system to the traditional mechanical caries removal in the primary dentition.
  
  
  METHODS
  The main relevant databases were searched: MEDLINE via PUBMED, Web of Science and SCOPUS. Complete caries removal, length of working time and need of local anesthesia were the outcomes evaluated.
  
  
  RESULTS
  A total of 195 studies were identified and complete analysis of 28 studies was performed; finally, 10 papers were included. The trials included involved a total of 348 patients for 532 treated teeth. There was no significant difference in terms of clinical efficacy between the Carisolv and the rotary instrument (z = 0.68, p = 0.50), whereas the treatment with Carisolv was significantly longer in terms of time with respect to the rotary instruments (z = 10.49, p < 0.01). The chemo mechanical technique reduces the need for local anesthesia, with a difference between two types of treatment near to statistical significance (z = 1.91 p = 0.06).
  
  
  CONCLUSIONS
  This systematic review indicates that the clinical efficacy of chemo-mechanical removal with Carisolv seems as reliable as the rotary instruments. However, the results should be interpreted cautiously due to the heterogeneity among study designs and to the shortage of available data. Further large-scale, well-designed randomized controlled trials are needed.
authors.affiliation: Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari , Sassari , Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Lai
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lara Capi
authors.forename: Fabio
authors.initials: F
authors.lastname: Cocco
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cagetti
authors.forename: Peter
authors.initials: P
authors.lastname: Lingström
authors.forename: Ulrica
authors.initials: U
authors.lastname: Almhöjd
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Campus
mesh_terms: D000772:Anesthesia, Local; D003731:Dental Caries / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000295:instrumentation / Q000379:methods*; D018698:Glutamic Acid / Q000627:therapeutic use*; D006801:Humans; D007930:Leucine / Q000627:therapeutic use*; D008239:Lysine / Q000627:therapeutic use*; D015203:Reproducibility of Results; D013997:Time Factors; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: C119934:Carisolv; D018698:Glutamic Acid; D007930:Leucine; D008239:Lysine
keywords: carisolv; chemo mechanical caries removal; dental caries; primary dentition; rotating instruments