Comparison of Carisolv system vs traditional rotating instruments for caries removal in the primary dentition: A systematic review and meta-analysis.

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. MATERIALS AND 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.

Effect of body weight and behavioural factors on caries severity in Mexican rural and urban adolescents.

OBJECTIVES: To investigate if, in Mexican adolescents, body weight and caries severity are associated, and if this association differs between rural and urban populations. METHODS: Adolescents from the rural area of Tepancan and the city of Veracruz were enrolled. Caries was recorded using the International Caries Detection and Assessment System and the body mass index (BMI) was calculated. Oral habits (toothbrushing, flossing, dental check-ups) and dietary patterns (sweets intake) were assessed. A dummy variable between BMI and living area (BMI/Area) was generated. Data were analysed using STATA and a multinomial logistic regression model was run, using caries severity as the dependent variable. RESULTS: Four-hundred and sixty-four subjects, 12-15 years of age, participated (rural = 240; urban = 224). The BMI and area of residence were significantly associated (χ2 = 12.59, P < 0.01). Area was also associated with caries severity (χ2 = 24.23, P < 0.01), with the highest number of caries in dentine recorded in participants from the rural area. The dummy variable BMI/Area was related to caries severity (χ2 = 27.47, P < 0.01): overweight adolescents with caries in dentine were most frequently found in the rural area. A higher prevalence of caries in enamel and a lower prevalence of caries in dentine (P < 0.01) were recorded in adolescents from the urban area, where better oral habits, but higher sweets intake (P = 0.04), were encountered. According to the multinomial logistic regression model, BMI/Area was significantly associated with caries severity (P < 0.01). CONCLUSIONS: Overweight was not associated with caries severity in the overall population, but it became a statistically significant risk indicator in adolescents living in the rural area.

Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study.

OBJECTIVES: This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device. METHODS: Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later. RESULTS: A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants. CONCLUSIONS: The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.