Kitsahawong Kemporn, Seminario Ana Lucia, Pungchanchaikul Patimaporn, Rattanacharoenthum Anoma, Sutthiprapaporn Pipop, Pitiphat Waranuch
Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.
School of Dentistry, Timothy A. DeRouen Center for Global Oral Health, University of Washington, Seattle, WA, United States.
Front Oral Health. 2024 Dec 3;5:1458530. doi: 10.3389/froh.2024.1458530. eCollection 2024.
Chemo-mechanical caries removal (CMCR) offers an alternative to conventional drilling for carious dentin removal, but limited evidence exists on its long-term effects on treating caries in primary teeth. The primary aims of this study were to compare CMCR to drilling in terms of restoration status and the presence of secondary caries after 24 months.
A randomized, parallel-group, single-blinded, controlled trial was conducted in Thailand. Participants were children aged 7-8 years with occlusal caries in second primary molars, randomly assigned to CMCR with Papacarie® ( = 242) or drilling ( = 246). All cavities were restored using glass ionomer cement. Completeness of caries removal was evaluated clinically by two blinded dentists, and patients' discomfort was measured using a facial visual analogue scale. Restoration status and development of secondary caries were assessed every six months clinically and every 12 months radiographically over a 2-year period.
Both groups achieved complete caries removal, but the CMCR took significantly longer than the drilling method (9 vs. 2.3 min, < 0.001). Children in the CMCR group reported significantly lower discomfort during treatment ( < 0.001). At 24 months, ten (4.6%) restorations in the CMCR group failed, compared to three (1.2%) in the drilling group. Clinically, four restorations (CMCR = 2, control = 2) exhibited secondary caries at the margin, while nine restorations (CMCR = 8, control = 1) showed radiographic evidence of secondary caries beneath the restoration. However, neither clinical nor radiographic evaluations revealed statistically significant differences in treatment outcomes at the two-year mark.
CMCR demonstrated comparable efficacy to conventional drilling for complete caries removal and restoration success at 24 months in primary teeth. Despite a longer chair time, it resulted in less discomfort during treatment.
https://clinicaltrials.gov/study/NCT01641861, identifier: NCT01641861.
化学机械去龋（CMCR）为去除龋坏牙本质提供了一种替代传统钻磨的方法，但关于其对乳牙龋病治疗的长期效果的证据有限。本研究的主要目的是比较CMCR和钻磨在24个月后的修复状况和继发龋的发生情况。
在泰国进行了一项随机、平行组、单盲、对照试验。参与者为7-8岁患有第二乳磨牙咬合面龋的儿童，随机分为使用Papacarie®进行CMCR治疗组（n = 242）和钻磨治疗组（n = 246）。所有龋洞均使用玻璃离子水门汀修复。由两名盲法牙医进行临床评估龋坏去除的完整性，并使用面部视觉模拟量表测量患者的不适感。在2年期间，每6个月进行临床评估，每12个月进行影像学评估修复状况和继发龋的发展情况。
两组均实现了龋坏的完全去除，但CMCR治疗所需时间显著长于钻磨方法（9分钟对2.3分钟，P < 0.001）。CMCR组的儿童在治疗期间报告的不适感显著更低（P < 0.001）。在24个月时，CMCR组有10个（4.6%）修复体失败，而钻磨组有3个（1.2%）。临床上，4个修复体（CMCR组 = 2个，对照组 = 2个）在边缘出现继发龋，而9个修复体（CMCR组 = 8个，对照组 = 1个）在修复体下方显示有继发龋的影像学证据。然而，在两年时，临床和影像学评估均未显示治疗结果有统计学上的显著差异。
在乳牙中，CMCR在24个月时去除龋坏和修复成功方面显示出与传统钻磨相当的疗效。尽管治疗时间更长，但它在治疗期间导致的不适感更小。
https://clinicaltrials.gov/study/NCT01641861，标识符：NCT01641861。
