Caries chemical-mechanical removal agents: a literature review

Klissia Romero Felizardo, Gabriella Fernanda Guedes, Evandro Agustineti dos Santos, Fernanda da Conceição Antônio Ferreira, Murilo Baena Lopes

Over the years, Dentistry has improved caries removal techniques to facilitate clinical routine, preserve healthy dental tissue, avoid pain and restore function and aesthetics. Among the recommended techniques are chemical-mechanical removal agents, a non-invasive technique that consists in the application of a proteolytic substance that smooths the infected tissue and preserves the affected one. Thus, the objective of this study was to conduct a review on the chemical and mechanical removal agents, indicating advantages and disadvantages, comparing caries removal time, amount of tissue removed (hardness), microbial flora reduction and whether or not anesthesia during lesion removal is necessary, in comparison with the conventional method of rotating instruments. This review was conducted by means of a search in PubMed and SciELO databases, using the following keywords, alone or in combination: “carious lesions”, “dentine carious”, “dental carious”, “Minimal Intervention Dentistry,” “selective caries removal”, “caries removal partial”, “excavation dentin”, “chemomechanical cavity preparation”, “chemomechanical caries removal”, in English and Portuguese. As a rule, the use of chemical-mechanical removal agents requires more time for caries removal and greater hardness of the residual dentin, compared with conventional removal technique, but these disadvantages are offset by the excellent acceptance of patients and less dependence of anesthesia. Moreover, the use of such agents exhibit effectiveness in reducing cariogenic microflora and no pain during treatment.

Keywords: Dental caries. Papain. Dentin. Temporary dental restoration. Pediatric dentistry.

How to cite: Felizardo KR, Guedes GF, Santos EA, Ferreira FCA, Lopes MB. Caries chemical-mechanical removal agents: a literature review. J Clin Dent Res. 2018 Sept-Dec;15(3):84-103. DOI: https://doi.org/10.14436/2447-911x.15.3.084-103.oar

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