Carisolv去龋对龋损内层牙本质粘接修复的影响

目的：评价Carisolv化学机械去龋对龋损内层牙本质与复合树脂之间粘接强度的影响。方法：12个牙合面中龋离体恒磨牙,随机等分为2组,分别用Carisolv化学机械法和牙钻机械法去龋,去龋后用复合树脂充填,低速切片机将牙齿切割成0.9mm×0.9mm×8mm的条形试件,微拉伸测试仪检测粘接强度,扫描电镜观察断裂模式。结果：Carisolv化学机械去龋和牙钻机械去龋后龋损内层牙本质与复合树脂之间的粘接强度分别为：22.98±4.17MPa,20.01±3.97Mpa,差异具有显著性意义（P〈0.05）;试件断裂以混合破坏为主。结论：Carisolv化学机械去龋可增加复合树脂与龋损内层牙本质的粘接强度。     

Carisolv化学机械去龋技术治疗乳牙龋病效果的系统评价

目的:评价Carisolv化学机械去龋技术治疗乳牙龋病的临床疗效。方法:计算机检索Co-chrane图书馆(2009年第2期)、PubMed(1966~2009)、MEDLINE(1966~2009)、Embase(1966~2009)、CBM(1978~2009)、CNKI(1989~2009)、VIP(1989~2009),同时采用手工检索相关资料,纳入Carisolv化学机械去龋技术与传统机械去龋比较治疗乳牙龋病的临床随机对照试验。按Cochrane系统评价方法评价纳入研究的质量,对同质研究采用RevMan 5.0软件进行Meta分析。结果:共纳入5个随机对照试验,合计162例病人,272个乳牙。结果显示:与传统手用去龋器械比较,Carisolv化学机械去龋技术去龋时疼痛程度较轻,对龋损去除效果、去龋时间、病人接受程度及术后并发症发生率的影响,两种方法差异无统计学意义。与传统机用器械的比较,Carisolv与高速涡轮机联合去龋法对龋损去除效果的差异无统计学意义;但Carisolv的去龋时间较长[WDM=3.09,95%CI(2.38,3.80)];而疼痛程度[RR=0.62,95%CI(0.42,0.90)]及病人接受度,Carisolv优于高速涡轮机联合去龋法。与慢速涡轮机联合去龋法的比较,Carisolv15 min内的龋损去净效率低[RR=0.61,95%CI(0.47,0.78)];去龋时间较长[WDM=6.69,95%CI(5.77,7.61)];但是,对于去龋的疼痛程度和病人的接受程度,两种方法差异无统计学意义。机用器械组中仅有1个研究进行了术后半年的随访,结果显示两种去龋方法术后并发症的发生率差异没有统计学意义。结论:Carisolv化学机械去龋技术治疗乳牙龋病能够有效去除龋损组织,但其去龋时间较长且去龋效率低于传统机用器械。Carisolv去龋引起的疼痛程度及病人的接受程度优于传统高速机用去龋器械,但无异于手用或慢速机用器械。由于本系统评价纳入研究的数量和质量有限,上述结论尚需开展更多大样本、设计良好、指标全面的临床随机对照试验来进一步验证。     

伢典化学机械去龋法治疗老年人根面龋的疗效观察

目的观察伢典(Carisolv)化学机械去腐法治疗老年人根面龋的疗效。方法门诊老年根面龋患者76例,随机分为伢典治疗组38例,对照组38例,分别采用伢典(Carisolv)凝胶与传统牙钻去龋,去龋后两组均行FujilⅡ玻璃离子水门汀充填,记录患者在治疗过程中的疼痛程度,比较1年后的治疗效果。结果 2组患者治疗1年后复查,成功率比较差异无统计学意义(P>0.05);2组患者去龋治疗时的疼痛程度比较差异有统计学意义(P<0.05)。结论伢典(Carisolv)化学机械去龋法治疗老年人根面龋安全、有效,大大减少患者治疗过程中的疼痛和不适,可推广应用。     

Carisolv化学机械去龋系统的临床评价

目的：评价Carisolv化学机械去龋系统的去龋时间、术中疼痛和近期疗效。方法：收集3～9岁儿童龋病患者80例,随机分为两组,每组40例,通过临床观察比较Carisolv化学机械去龋系统和常规车针去龋系统的去龋时间、术中疼痛、近期疗效。结果：窝洞制备时Carisolv较车针耗时要长（P〈0.05）,术中疼痛发生率有显著差异（P〈0．05）,近期疗效评价两组的差别无统计学意义（P〉0．05）。结论：Carisolv化学机械去龋系统可用于儿童龋病的治疗。     

Carisolv化学机械去龋后恒牙牙本质表面形态的扫描电镜观察

目的：观察用Carisolv化学机械去龋后恒牙牙本质的表面形态.方法：新鲜离体的中、深龋恒磨牙10个,沿龋洞中心纵剖为两部分,并随机分为2组,实验组用Carisolv去龋,对照组用慢速球钻去龋,然后在扫描电镜下放大500、1000倍, 各选择3个视野观察, 用3级标准对牙本质表面的碎屑和玷污层进行盲法评分比较.结果：与对照组相比,Carisolv组牙本质表面的碎屑和玷污层较少, 差异具有显著性意义（P＜0.01）.结论： 用Carisolv能有效去除龋损牙本质和玷污层,并形成有利于复合树脂黏结的界面.     

Carisolv化学机械去龋技术治疗乳牙龋病的临床评价

目的：评价Carisolv化学机械去龋技术用于乳牙龋病治疗的临床疗效。方法：选取169个龋损乳牙，实验组104个采用Carisolv化学机械去龋，对照组73个采用牙钻去龋。去龋后每组再随机分成A、B两组，分别使用玻璃离子和复合体充填。比较临床治疗效果。结果：与对照组相比，Cafisolv化学机械去龋痛苦小（P〈0．01），在去龋时间、继发龋形成及充填体脱落方面两组无明显差异，而对牙髓的不良影响对照组高于实验组（P〈0．01）。使用不同充填材料的两组在术后并发症方面无明显差异。结论：在乳牙龋病的治疗中，使用Carisolv化学机械去龋较牙钻去龋更具优势。     

Carisolv化学机械去腐技术对微拉伸粘拉力的影响

目的比较恒牙牙本质龋采用Carisolv化学机械法和使用球钻的传统方法去腐后的窝洞和树脂充填材料之间的微拉伸粘接力的大小。方法将新鲜拔除的且有冠部牙本质龋的28颗恒牙随机分为两组,每组14颗,一组使用Carisolv化学机械法去腐,另一组用慢速球钻去腐。去净腐质后,每颗牙用Singlebond粘接剂粘接,3M通用树脂充填。样本置于37℃生理盐水中保存24小时,沿粘接界面较平坦处切取截面大小约0.5mm×1.5mm的小柱,施以1mm/min的拉伸速度,测量并计算单位面积的微拉伸粘接力。结果Carisolv组(20.9±3.6MPa)和球钻组(21.5±4.3MPa)的微拉伸粘接力差异无显著性(P>0.05)。结论Carisolv的使用不影响牙本质和树脂的粘接力。     

乳牙Carisolv去龋的扫描电镜观察

目的:用扫描电镜技术对化学机械去龋法和传统去龋法去除乳牙龋损牙本质后的微观形态进行比较.方法:选取12个深龋的离体乳磨牙,随机分为对照组、机械法去龋组、Carisolv去龋组,去龋后用扫描电子显微镜分别观察3组乳磨牙窝洞底部形态.结果:对照组牙本质崩解破坏,可见碎屑和残渣,牙本质小管形态不完整;机械法去龋组牙本质表面有不规则的颗粒和碎片,有玷污层形成,牙本质小管口堵塞;Carisolv去龋组未见碎屑和残渣以及玷污层,牙本质小管清楚可见.结论:Carisolv去龋法对乳牙的牙本质龋效果优于机械法去龋组.     

CarisolvⅢ化学机械去龋法对牙本质黏结强度影响研究

目的 探讨化学机械去龋制剂CarisolvⅢ对牙本质黏结强度的影响。方法 收集2014年3—6月在中国医科大学口腔医学院口腔颌面外科门诊因各种原因拔除的龋坏恒磨牙40颗,将每颗牙齿沿龋洞中心纵剖为两部分（即为两组,每组40个样本）。CarisolvⅢ去龋组：采用CarisolvⅢ化学机械法去龋;机械去腐组：采用慢速球钻去龋。将两组再各自随机均分为两组,分别用3M ESPE自酸蚀黏结剂和Adper Single Bond 2全酸蚀黏结剂黏结,然后用3M Z350光固化复合树脂分层充填。制作各样本的微拉伸试件,测试微拉伸黏结强度并进行比较分析。结果 CarisolvⅢ去龋组的微拉伸黏结强度：采用3M ESPE自酸蚀黏结系统为（19.50 ± 6.83）MPa,采用Adper Single Bond 2全酸蚀黏结系统为（24.35 ± 7.97）MPa。机械去腐组的微拉伸黏结强度：采用3M ESPE自酸蚀黏结系统为（18.10 ± 7.55）MPa,采用Adper Single Bond 2全酸蚀黏结系统为（23.50 ± 8.33）MPa。采用相同黏结系统的两种去龋方法的微拉伸黏结强度比较,差异无统计学意义（P > 0.05）;而同一种去龋法,采用Adper Single Bond 2全酸蚀黏结系统的微拉伸黏结强度高于3M ESPE自酸蚀黏结系统,差异有统计学意义（P < 0.05）。结论 CarisolvⅢ化学机械去龋法能够获得与机械去腐法同样的牙本质黏结强度。     

乳牙化学机械去龋

目的比较化学机械去龋和常规车针钻磨去龋间去龋时间、局麻需要及患儿的配合情况等的差异。方法选择129颗患牙合面牙本质龋的乳磨牙为实验样本,随机分组,分别采用化学机械去龋或常规车针钻磨去龋,记录去龋时间、局麻需要及患儿的配合程度。结果43颗牙常规去龋,86颗化学机械去龋。化学机械去龋平均时间为9.3±3.6分钟,而常规去龋为3.2±1.2分钟,二者差异有显著性;与常规去龋相比,化学机械去龋可以减少局麻的需要;而且化学机械去龋组患儿的配合程度也较常规去龋组的高,但差异没有显著性。结论化学机械去龋能有效去除乳牙龋坏,减少局麻的需要。     

乳牙化学去龋法的细菌学研究

目的：比较化学去龋法和机械去龋法清除细菌的效果。方法：选取40个龋坏深至牙本质的乳磨牙，中龋或深龋，随机分为化学法去龋组和机械法去龋组，每组20个牙，去龋前后使用无菌挖匙对龋坏牙本质进行取样，分别在4种不同的培养基上进行厌氧培养和计数。结果：两种方法去龋后，除机械法去龋组放线菌外，两种方法其他细菌数显著减少，有统计学意义（P〈0．05），化学法去龋组比机械法去龋组的总菌数量减少更显著（p〈0．05）。结论：化学去龋法比机械去龋法清除乳牙龋坏细菌效果好。     

Carisolv去腐对155例牙科畏惧症患儿影响的观察

目的　比较Carisolv去腐和传统车针去腐对牙科畏惧症患儿的影响。方法　选择门诊龋齿患儿300例,其中采用Carisolv去腐155例,传统车针去腐145例,比较2组患儿的CFSS-DS评分值、术中行为分级、疼痛情况和去腐时间。结果　2组患儿CFSS-DS评分值治疗前无显著性差异,治疗后有显著性差异;2组患儿术中行为分级、疼痛率和去腐时间均有显著性差异。结论　Carisolv去腐可有效缓解儿童对牙科的畏惧,值得临床推广。     

In vitro comparison of the efficacy of Carisolv and conventional rotary instrument in caries removal

summary The purpose of this in vitro study was to compare the efficacy of a new chemomechanical caries removal agent, Carisolv^TM (MediTeam AB, Sävedalen, Sweden), with conventional slow‐speed rotary instrument (bur). Fourteen extracted human molar teeth with deep dentine caries and no enamel coverage were selected for the study. Their laser fluorescence values were over 30 (DIAGNOdent^®; KaVo, Biberach, Germany). After the teeth were sectioned through the centre of the carious lesion, one half was removed with conventional drilling (bur); the other half was removed with Carisolv gel. Removal of carious dentine was continued until the lesion was deemed caries‐free by visual and tactile criteria. The preparation time for each caries removal technique was also noted. The two halves of each tooth were fixed in 10% buffered‐formaldehyde for 1 week. They were then decalcified, dehydrated and embedded in paraffin blocks for histological studies. After taking serial sections of 5 μm thickness, sections were mounted on glass slides, deparaffinized, dehydrated and stained with toluidine blue for observation under a light microscope. Each section was examined for the presence of bacteria. Complete removal of caries was achieved in 13 (93%) of 14 conventionally prepared teeth, and 5 (36%) of 14 chemomechanically prepared teeth (P < 0·05). Mean (±SD) time for caries removal was 272 s (±53·3) with Carisolv, and 116 s (±49·4) with drilling. The results of this study suggest that conventional rotary instrument (bur) was more effective than Carisolv in removal of carious tissue and also takes shorter time.     

Carisolv(伢典)微创化学机械去龋法治疗老年人龋齿的临床研究

目的:评价伢典微创化学机械去龋法治疗老年人龋齿的有效性和安全性.方法:门诊老年龋齿病人48例,随机分为伢典治疗组30例和对照组18例,分别采用伢典凝胶去龋和常规磨牙去龋,比较两组病人的感受,治疗所用时间,治疗效果.结果:伢典治疗组病人痛苦小,安全,但所用时间长于对照组.结论:伢典化学机械去龋法治疗老年人龋齿安全、有效、无痛.     

Evaluation of Carisolv for the chemo-mechanical removal of primary root caries in vivo

The objective of this study was to evaluate a new chemo-mechanical method (Carisolv) for the removal of primary root caries in vivo in terms of efficiency, treatment time and patient perception. Thirty-eight patients participated in an open, randomised and controlled study. Of the 60 root carious lesions included, 34 were randomised for chemo-mechanical treatment and 26 for drilling. A within-subject comparison was used whenever the patient had two cavities, which was the case for 22 subjects. All the Carisolv-treated cavities became caries free, as did all but one of those treated with drilling, as judged by an independent examiner. Only 4 of 34 patients asked for anaesthesia in the Carisolv group compared with 6 of 26 patients in the drilling group. Of those who did not use anaesthesia, 12 individuals in the drilling group experienced some pain compared with none in the chemo-mechanical group (p<0.001). The mean treatment time for the Carisolv method was 5.9+/-2.2 min, compared with 4.5+/-2.0 min for drilling; time for anaesthesia excluded (p<0.05). No negative reactions or adverse effects were recorded during the study. All 55 teeth examined in the 1-year follow-up were found to be sensitive using an electric pulp tester, and there was no difference regarding the condition of fillings between the lesions treated with Carisolv and drilling. It can be concluded that root caries can be effectively removed using the Carisolv method. The longer treatment time was compensated by less need for anaesthesia.     

伢典微创技术在老年根面龋治疗中的临床应用

目的 探讨伢典微创技术在老年根面龋治疗中的临床效果及可行性.方法 筛选有对称根面龋的老年患者120例,采用自身半口对照法,分为实验组及对照组,实验组用伢典凝胶去腐,对照组用传统牙钻去腐,去腐后2组均采用3M玻璃离子水门汀充填,比较2组术中所用的治疗时间、疼痛程度.随访18个月,评价临床疗效.结果 实验组去腐时间长于对照组(P<0.05),但疼痛程度低于对照组(P<0.05).2组随访18个月的临床充填效果比较,差异无统计学意义(P>0.05).结论 伢典凝胶微创技术在老年根面龋的治疗中安全、有效,可降低老年患者对口腔治疗的紧张和恐惧,值得临床推广使用.     

Evaluation of the chemomechanical removal of dentine caries in vivo with a new modified Carisolv gel

Carisolv is a minimally invasive method for softening and removing dentine caries. A new, modified Carisolv gel has been developed in order to optimise the efficiency if its chemical caries dissolution. The aim of the present study was to compare the caries removal efficiency of the original gel with that of the new gel, which contains almost double the concentration of sodium hypochlorite. Ten dentists treated 202 cavities in 170 patients; 104 cavities were randomised to the new gel and 98 to the original gel. Their mean treatment times for caries removal were 6.7±4.1 min and 7.6±4.2 min, respectively (P>0.05). In close-to-pulp lesions, constituting 32% of the cavities, the mean times for caries removal were 9.0±7.0 min and 11.6±4.4 min for the new and original gels, respectively (P<0.01). Questionnaires revealed that 81% of the patients preferred chemomechanical treatment to drilling. In conclusion, the improved efficiency of the modified Carisolv gel did reduce the time for caries removal in deep lesions. However, it still needs more time than conventional drilling.     

伢典三代凝胶微创治疗乳磨牙深龋的疗效观察

摘要：目的 对比分析伢典凝胶微创去腐与传统牙钻去腐方案对乳磨牙深龋的治疗效果,以指导临床治疗疾病。方法 纳入2015年4月至2016年4月于我院接受治疗的乳磨牙深龋患儿132例（218颗）为对象,采用随机数字表法将患儿均分为2组。观察组66例（110颗）接受伢典凝胶微创治疗;对照组66例（108）颗接受传统牙钻去腐。对比每颗牙处理时间、处理期间患儿疼痛情况,术后2周监测牙髓活力,术后1年复查监测牙髓活力及治疗相关并发症情况。结果 观察组患牙处理时间（11.3±5.2）min,明显长于对照组（9.8±3.2）min,期间患儿疼痛感觉明显轻于对照组,随访1年时观察组继发龋、充填物松动、牙髓炎发生率分别为2.7%、1.8%、0.0%,均明显低于对照组16.7%、9.3%、6.5%,上述差异均有统计学意义（P＜0.05）。结论 伢典凝胶微创治疗乳磨牙深龋,虽会明显增加患牙处理时间,但可明显减轻术中疼痛、降低术后并发症,优势明显。     

伢典化学与机械去龋法的光镜研究

目的：通过对伢典和传统牙钻去除牙本质龋后的磨片观察，评价伢典的去龋效果。方法：选取龋损已到牙本质的离体牙9个，分为对照组、机械组、伢典组3组，每组3个牙。对照组不处理，机械组用传统牙钻去龋，伢典组用伢典去龋。然后磨制成磨片，在光学显微镜下观察去龋效果。结果：对照组能观察到明显的龋损病理组织结构。伢典组、牙钻组的龋损组织被完全去除。结论：伢典能有效去除龋损组织。