The Efficacy of Chemo-Mechanical Removal of Dentin Carious lesion
The efficacy of chemo-mechanical removal of dentin carious iesion
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본 연구는 우식의 기계적 제거와 기계화학적 제거의 효과를 비교, 평가하고자 하였으며, 기계적 제거방법은 저속의 round bur로, 기계 화학적 제거 방법은 Carisolv로 우식을 제거한 후, 잔존 우식을 확인하여 소요시간을 측정하였고, 또 실험실에서 발치한 우식 대구치 20개를 위 두 가지 방법으로 우식을 제거 후, Villanueva bone stain액으로 염색하고 표본을 제작 후 관찰하여 다음의 결론을 얻었다; 1. 우식제거에 평균소요시간은 기계화학적 제거가 기계적인 제거보다 1.5 배 더 길게 나타났다 (P < 0.05). 2. 우식제거에 평균소요시간은 소구치보다 대구치에서 더 길었고, 전치에서 가장 적은것으로 나타났다 (P < 0.05). 3. 상하악에서는 차이가 없었다 (P > 0.05). 4. 기계화학적 방법으로 우식 상아질을 제거 시 잔존 우식 상아질이 관찰되었 으며 두 방법 모두 우식 상아질을 제거한 표면에서는 도말층을 관찰할 수 없었다.
Abstract
Mechanical removals in decayed teeth have been performed using drill and sharp hand instruments. These methods have some disadvantages such as pain, local anesthesia and overextended cavities. Therefore chemo-mechanical excavation of dentin carious lesions has been introduced. The purpose of this study was to evaluate the efficacy of traditional mechanical methods using burs and chemo-mechanical methods (Carisolv) of caries dentin. Mechanical caries removal was carried with low speed round bur. Chemo- mechanical caries excavation was performed with Carisolv (Medi-team), using the Carisolv hand instruments. The mean time to remove caries with two different methods was evaluated and the data analyzed with SPSS software (ver 11.5) by t-test (p < 0.05). For histomorphometry of caries removal were also carried with mechanical or chemo- mechanical (Carisolv) methods from 20 extracted caries permanent molars. Complete caries removal was verified with a #23 sharp explorers, Caries Detector (Kuraray Co. Japan), and standard apical radiography. 1. Chemo-mechanical method was taken more times than mechanical method (1.5 fold) (p < 0.05). 2. Excavation for caries took more time for molar lesion than premolar lesion, and the least time was taken to remove the caries in incisor lesion (p < 0.05). 3. There were no significant differences to remove the caries between the maxilla and mandible (P > 0.05). 4. The remaining carious dentin was detected after the chemo-mechanical removal of the carious dentin, and no smear layer were seen after the mechanical and chemo-mechanical removal of the carious dentin.
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