Chemo-mechanical removal versus conventional removal for deep caries lesion

Area of Science:

• Dentistry
• Conservative Dentistry
• Caries Management

Background:

• Traditional dental caries management involves total removal of carious tissue.
• This method can cause patient distress and fear.
• Conservative techniques like chemo-mechanical removal are emerging but debated.

Purpose of the Study:

• To evaluate the effectiveness and safety of chemo-mechanical caries removal.
• To synthesize evidence from systematic reviews on conservative caries removal.

Main Methods:

• Systematic search of Epistemonikos database, including MEDLINE, EMBASE, and Cochrane.
• Data extraction from systematic reviews and reanalysis of primary studies.
• Meta-analysis and GRADE approach for evidence certainty assessment.

Main Results:

• Seven systematic reviews with 34 studies (30 randomized trials) were included.
• Chemo-mechanical removal likely reduces anesthesia need and patient pain.
• May decrease restoration failure risk but increase procedure time for deep caries.

Conclusions:

• Evidence suggests chemo-mechanical caries removal is beneficial but with low certainty.
• Uncertainty exists regarding its impact on pulp exposure risk (very low certainty).
• Further high-quality research is needed to confirm findings.