Kemomekanik Çürük Uzaklaştırma Yöntemleri

Yıl 2024, Cilt: 34 Sayı: 3, 230 - 237, 28.07.2024

Ayfer Burcu Aytar Ayşegül Ölmez

https://doi.org/10.5152/CRDS.2022.6156

Öz

Kemomekanik çürük uzaklaştırma yöntemi; minimal invaziv diş hekimliği felsefesine dayandırılarak geliştirilen, enfekte dentinin kemomekanik ajanla kimyasal olarak yumuşatıldığı ve yumuşayan dentinin ekskavatörle nazikçe uzaklaştırıldığı, invaziv olmayan bir teknik olarak tanımlanmaktadır. Bu yöntem, kısmen bozulmuş kollajenin daha fazla bozulmasına neden olur ve sadece enfekte olmuş dentin tabakalarını uzaklaştırır. Hangi dentinin uzaklaştırılacağını ve hangi dentinin bırakılacağını göstermesi bu yöntemin en önemli özelliğidir. Bu yöntem özellikle çocuklar ve dental anksiyetesi olan hastalar arasında yüksek kabul görmektedir. Kemomekanik çürük uzaklaştırma ajanları; sodyum hipoklorit (NaOCl) bazlı ve enzimatik bazlı olmak üzere iki gruba ayrılmaktadır. Sodyum Hipoklorit (NaOCI) bazlı olanlar; GK-101, GK-101E (Caridex) ve Carisolv’dür. Enzimatik bazlı olanlar; Papacarie, Apacaries jel, Carie-Care, Biosolv ve Brix-3000’dir. Bu derlemenin amacı kemomekanik çürük uzaklaştırma yöntemlerini ve çalışma mekanizmalarını anlatmaktır.

Anahtar Kelimeler

minimal invaziv diş hekimliği, Kemomekanik çürük uzaklaştırma, Kemomekanik çürük uzaklaştırma yöntemi

Kemomekanik Çürük Uzaklaştırma Yöntemleri: Bir Derleme

Öz

Kemomekanik çürük uzaklaştırma yöntemi; minimal invaziv diş hekimliği felsefesine dayandırılarak geliştirilen, enfekte dentinin kemomekanik ajanla kimyasal olarak yumuşatıldığı ve yumuşayan dentinin ekskavatörle nazikçe uzaklaştırıldığı, invaziv olmayan bir teknik olarak tanımlanmaktadır. Bu yöntem, kısmen bozulmuş kollajenin daha fazla bozulmasına neden olur ve sadece enfekte olmuş dentin tabakalarını uzaklaştırır. Hangi dentinin uzaklaştırılacağını ve hangi dentinin bırakılacağını göstermesi bu yöntemin en önemli özelliğidir. Bu yöntem özellikle çocuklar ve dental anksiyetesi olan hastalar arasında yüksek kabul görmektedir. Kemomekanik çürük uzaklaştırma ajanları; sodyum hipoklorit (NaOCl) bazlı ve enzimatik bazlı olmak üzere iki gruba ayrılmaktadır. Sodyum Hipoklorit (NaOCI) bazlı olanlar; GK-101, GK-101E (Caridex) ve Carisolv’dür. Enzimatik bazlı olanlar; Papacarie, Apacaries jel, Carie-Care, Biosolv ve Brix-3000’dir. Bu derlemenin amacı kemomekanik çürük uzaklaştırma yöntemlerini ve çalışma mekanizmalarını anlatmaktır.

Anahtar Kelimeler

Kemomekanik çürük uzaklaştırma, minimal invaziv diş hekimliği

Kaynakça

• 1. Avunduk ATB, Bağlar S. Alternatif çürük uzaklaştırma yöntemleri. Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi. 2019;25(3):360-70.
• 2. Smaïl‐Faugeron V, Glenny AM, Courson F, Durieux P, Muller‐Bolla M, Chabouis HF. Pulp treatment for extensive decay in primary teeth. Cochrane Database of Systematic Reviews. 2018;5(5):1-32.
• 3. Li R, Zhao Y, Ye L. How to make choice of the carious removal methods, Carisolv or traditional drilling? A meta‐analysis. Journal of Oral Rehabilitation, 2014;41(6):432-42.
• 4. Ricketts D, Kidd E, Innes NP, Clarkson JE. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database of Systematic Reviews. 2006;3(3):1-14.
• 5. Mhatre S, Sinha S, Bijle MNA, Thanawala EA. Chemomechanical caries removal system: A brief review. International Journal of Clinical Dental Science. 2011;2(2):52-7.
• 6. Kitsahawong K, Seminario AL, Pungchanchaikul P, Rattanacharoenthum A, Pitiphat W. Chemomechanical versus drilling methods for caries removal: An in vitro study. Brazilian Oral Research. 2015;29(1):1-8.
• 7. Venkataraghavan K, Kush A, Lakshminarayana C, Diwakar L, Ravikumar P, Patil S, et al. Chemomechanical caries removal: A review & study of an indigenously developed agent (Carie-Care TM gel) in children. Journal of International Oral Health. 2013;5(4):84-90.
• 8. Jingarwar M, Bajwa N, Pathak, A. Minimal intervention dentistry: A new frontier in clinical dentistry. Journal of Clinical and Diagnostic Research. 2014;8(7):4-8.
• 9. Hegde MN, Abhishek, M. Chemomechanical caries removal: A conservative and pain free approach. Advanced Research in Gastroenterology & Hepatology. 2017;5(3):69-71.
• 10. Hamama H, Yiu C, Burrow, M. Current update of chemomechanical caries removal methods. Australian Dental Journal. 2014;59(4):446-56
• 11. Goldman M, Kronman JH. A preliminary report on a chemomechanical means of removing caries. The Journal of the American Dental Association. 1976;93(6):1149-53
• 12. Hamama H, Yiu C, Burrow M, King N. Systematic review and meta-analysis of randomized clinical trials on chemomechanical caries removal. Operative Dentistry. 2015;40(4):167-78.
• 13. Ganesh M, Parikh D. Chemomechanical caries removal (CMCR) agents: Review and clinical application in primary teeth. Journal of Dentistry and Oral Hygiene. 2011;3(3):34-45.
• 14. Coşgun MT, Öz FT. Kemomekanik çürük temizleme yöntemindeki güncel gelişmeler. Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi. 2019;25(3):344-50.
• 15. Hamama H, Yiu C, Burrow MF, King N. Chemical, morphological and microhardness changes of dentine after chemomechanical caries removal. Australian Dental Journal. 2013;58(3):283-92.
• 16. Habib C, Kronman J, Goldman M. A chemical evaluation of collagen and hydroxyproline after treatment with GK-101 (N-chloroglycine). Pharmacology and Therapeutics in Dentistry. 197;2(3):209-15.
• 17. Kurosaki N, Sato Y, Iwaku M, Fusayama T. Effect of a carious dentin softener on the dentin and pulp. Journal of Prosthetic Dentistry. 1977;38(2):169-73.
• 18. Ricketts DNJ, Pitts NB. Novel operative treatment options. In: Pitts NB, eds. Detection, Assessment, Diagnosis and Monitoring of Caries. 1st Ed. Basel, Switzerland: Karger; 2009. p.174-87.
• 19. Ali A, Koller G, Foschi F, Andiappan M, Bruce K, Banerjee A, et al. Self-limiting versus conventional caries removal: A randomized clinical trial. Journal of Dental Research. 2018;97(11):1207-13.
• 20. Keenan AV, Congiusta MA. Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth. Evidence-based Dentistry. 2016;17(2):44-5.
• 21. Kumar KS, Prasad MG, Sandeep RV, Reddy SP, Divya D, Pratyusha K. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community based setting: A comparative in vivo study. European Journal of Dentistry. 2016;10(3):386-91.
• 22. Bussadori SK, Castro LC, Galvão AC. Papain gel: A new chemomechanical caries removal agent. Journal of Clinical Pediatric Dentistry. 2006;30(2):115-9.
• 23. Goyal PA, Kumari R, Kannan V, Madhu S. Efficacy and tolerance of papain gel with conventional drilling method: A clinico-microbiological study. Journal of Clinical Pediatric Dentistry. 2015;39(2):109-12.
• 24. Schwendicke F. Caries removal in primary teeth using Papacarie. Evidence-based Dentistry. 2018;19(3):74-5
• 25. AlHumaid J. Efficacy and efficiency of papacarie versus conventional method in caries removal in primary teeth: An SEM study. Saudi Journal of Medicine & Medical Sciences. 2020;8(1):41-5.
• 26. Nair S, Nadig RR, Pai VS, Gowda Y. Effect of a papain-based chemomechanical agent on structure of dentin and bond strength: An in vitro study. International Journal of Clinical Pediatric Dentistry. 2018;11(3):161-6.
• 27. Kotb R, Elkateb M, Ahmed A, Kawana K, El Meligy O. Dentin topographic features following chemomechanical caries removal in primary teeth. Journal of Clinical Pediatric Dentistry. 2016;40(6):472-9.
• 28. Kush A, Thakur R, Patil SDS, Paul ST, Kakanur M. Evaluation of antimicrobial action of Carie Care™ and Papacarie Duo™ on Aggregatibacter actinomycetemcomitans a major periodontal pathogen using polymerase chain reaction. Contemporary Clinical Dentistry. 2015;6(4):534-8.
• 29. Juntavee A, Peerapattana J, Ratanathongkam A, Nualkaew N, Chatchiwiwattana S, Treesuwan P. The antibacterial effects of Apacaries gel on Streptococcus mutans: An in vitro study. International Journal of Clinical Pediatric Dentistry. 2014;7(2):77-81.
• 30. Sontakke P, Jain P, Patil AD, Biswas G, Yadav P, Makkar DK, et al. A comparative study of the clinical efficiency of chemomechanical caries removal using Carie-Care gel for permanent teeth of children of age group of 12–15 years with that of conventional drilling method: A randomized controlled trial. Dental Research Journal. 2019;16(1):42-6.
• 31. Duarte S, Gregoire S, Singh AP, Vorsa N, Schaich K, Bowen WH, et al. Inhibitory effects of cranberry polyphenols on formation and acidogenicity of Streptococcus mutans biofilms. FEMS Microbiology Letters. 2006;257(1);50-6.
• 32. Matsumoto M, Hamada S, Ooshima T. Molecular analysis of the inhibitory effects of oolong tea polyphenols on glucan-binding domain of recombinant glucosyltransferases from Streptococcus mutans MT8148. FEMS Microbiology Letters. 2003;228(1):73-80.
• 33. Xiao Y, Liu T, Zhan L, Zhou X. The effects of tea polyphenols on the adherence of cariogenic bacterium to the salivary acquired pellicle in vitro. West China Journal of Stomatology. 2000;18(5):336-9.
• 34. Juntavee A, Juntavee N, Peerapattana J, Nualkaew N, Sutthisawat S. Comparison of marginal microleakage of glass ionomer restorations in primary molars prepared by chemo-mechanical caries removal (CMCR), erbium: yttrium aluminum-garnet (Er: YAG) laser and atraumatic restorative technique (ART). International Journal of Clinical Pediatric Dentistry. 2013;6(2):75-9.
• 35. Thakur R, Patil SDS, Kush A, Madhu K. SEM analysis of residual dentin surface in primary teeth using different chemomechanical caries removal agents. Journal of Clinical Pediatric Dentistry. 2017;41(4):289-93.
• 36. Hegde AM, Preethi V, Shetty A, Shetty S. Clinical evaluation of chemomechanical caries removal using Carie-care system among school children. Nitte University Journal of Health Science. 2014;4(3):80-4.
• 37. Aswathi KK, Rani SP, Athimuthu A, Prasanna P, Patil P, Deepali K. Comparison of efficacy of caries removal using polymer bur and chemomechanical caries removal agent: A clinical and microbiological assessment-An in vivo study. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2017;35(1):6-13.
• 38. Hacıoğulları Dİ, Ulusoy N, Cengiz E. Derin dentin çürüklerinin tedavisinde alternatif yeni yöntemler. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2016; 16:120-36.
• 39. Neves AA, Coutinho E, De Munck J, Lambrechts P, Van Meerbeek B. Does DIAGNOdent provide a reliable caries-removal endpoint? Journal of Dentistry. 2011;39(5):351-60.
• 40. Clementino-Luedemann TN, Ilie ADN, Hickel R, Kunzelmann KH. Microcomputed tomographic evaluation of a new enzyme solution for caries removal in deciduous teeth. Dental Materials Journal. 2006;25(4):675-83.
• 41. Banerjee A, Kellow S, Mannocci F, Cook R, Watson T. An in vitro evaluation of microtensile bond strengths of two adhesive bonding agents to residual dentine after caries removal using three excavation techniques. Journal of Dentistry. 2010;38(6):480-9.
• 42. Neves AA, Coutinho E, De Munck J, Van Meerbeek B. Caries removal effectiveness and minimal invasiveness potential of caries excavation techniques: a micro-CT investigation. Journal of Dentistry. 2011;39(2):154-62.
• 43. Felizardo KR, Alvarenga Barradas NP, Guedes GF, Ferreira FDCA, Lopes MB. Use of BRIX-3000 enzymatic gel in mechanical chemical removal of caries: Clinical case report. Journal of Health Sciences. 2018;20(2):87-93.
• 44. 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. Journal of Baghdad College of Dentistry. 2019;31(2):7-13.
• 45. Ismail MMM, Haidar AH. Evaluation of the efficacy of caries removal using Papain gel (Brix 3000) and smart preparation bur: In vivo comparative study. Journal of Pharmaceutical Sciences and Research. 2019;11(2):444-9.
• 46. Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemomechanical caries removal agents (2.25% sodium hypochlorite gel and Brix-3000), in caries removal and patient cooperation: A randomized controlled clinical trial. Journal of Dentistry. 2020;93(103280):1-5.