Dental caries are bacterial induced necrosis of tooth ... · Dental caries are bacterial induced necrosis of tooth structure Treatment should focus on the removal of necrotic tissue

Dental caries areDental caries arebacterial induced necrosis of tooth structurebacterial induced necrosis of tooth structure

Treatment should focus on the removal of necrotic tissue with a bacteriocidal approach.

Carisolv® a product from ORASOLV AB

Cases and product info

“Since the invention and application of rotary instruments, the operative treatment of carious lesions has often resulted in considerable removal of tooth structure.”

Banerjee A, Watson TF, Kidd EA. Br Dent J. 2000 May 13;188(9):476-82



Minimally invasive dentistry focuses on preserving Minimally invasive dentistry focuses on preserving

healthy and sound tissue.healthy and sound tissue.

The art of intervention lies in NOT removing more than The art of intervention lies in NOT removing more than

necessary.necessary.



““In modern dentistry the primary aim when excavating In modern dentistry the primary aim when excavating

carious dentin is to eradicate only the highly infected, carious dentin is to eradicate only the highly infected,

irreversibly irreversibly demineralizeddemineralized and denatured biomassand denatured biomass…”…”

Banerjee A, Watson TE, Kidd EA. Dent Update 2000 Jul-Aug;27(6):272-6



In a study aimed to evaluate the efficiency (time taken) and In a study aimed to evaluate the efficiency (time taken) and

effectiveness (quantity of dentine removed) of carious dentine effectiveness (quantity of dentine removed) of carious dentine

excavation excavation ……

……bur excavation was quickest but bur excavation was quickest but overpreparedoverprepared cavitiescavities……

……CarisolvCarisolv®® excavation was slower but excavation was slower but removed adequate removed adequate

quantities of tissuequantities of tissue……

Banerjee A, Kidd EA, Watson TF. Caries Res 2000 Mar-Apr;34(2):144-50



Dec 2005:Dec 2005:

62 abstract in 62 abstract in PubMedPubMed responding responding

to search word to search word ““CarisolvCarisolv”” !!

If search term If search term ““chemomechanicalchemomechanical””

also included,also included,

PubMedPubMed lists 91 abstracts !lists 91 abstracts !

The The CarisolvCarisolv method was method was

introduced on the market in 1997 !introduced on the market in 1997 !



The The CarisolvCarisolv®® method was method was

introduced on the market in 1997 !introduced on the market in 1997 !



Carisolv® is the best studied

method for caries removal

Carisolv® removes necrotic, decayed, dentine and

leaves healthy tooth structure unaffected –

-a minimal invasive approach when biology is an important issue.

Arvidson A., et al. Biomaterials 2002 Oct;23(19):3977-83Banerjee A., et al. Caries Res 2000;34(2):144-150Hanning M. Clin Oral Investig 1999;3(3):155-9Sakoolnamarka R., et al. Aust Dent J 2002 Jun;47(2):116-22Wennerberg A., et al. Eur J Oral Sci 1999;107(4):297-306Yazici AR., et al. Oper Dent 2002 Jul-Aug;27(4):360-6



Carisolv® has NO effect on sound and healthy

dentin.

Carisolv® leaves a rougher dentin surface suitable

for modern restauration techniques.

Haak R., et al. Eur J Oral Sci 2000;108(5):449-455

Hosoya Y., et al. J Dent 2001 May;29(3):163-171

Kubo S., et al. Oper Dent 2002 Jul-Aug;27(4):387-95Carisolv® a product from ORASOLV AB


CarisolvCarisolv®® does not elicit does not elicit

adverse effect onto pulp adverse effect onto pulp

tissue.tissue.

Braun A., et al.Braun A., et al. QuintessenzQuintessenz 2000;51(5):4612000;51(5):461--469469

DammaschkeDammaschke T., et al.T., et al. J Dent 2001;29(4):283J Dent 2001;29(4):283--290290

DammaschkeDammaschke T., et alT., et al J Dent 2002 Jan;30(1):59J Dent 2002 Jan;30(1):59--6565

Young C., et al.Young C., et al. J Dent 2001;29(4):275J Dent 2001;29(4):275--281281



Clinical and histological study on oral mucosa Clinical and histological study on oral mucosa

after prolonged exposure to after prolonged exposure to CarisolvCarisolv®® did not did not

show any inflammatory reactions.show any inflammatory reactions.

ArvidssonArvidsson A., et al. A., et al. GerodontologyGerodontology 2001 Dec;18(2):1092001 Dec;18(2):109--1313



CarisolvCarisolv®® safely and selectively removes ALL safely and selectively removes ALL

the decayed dentine the decayed dentine –– leaving a caries free leaving a caries free

and clean surface.and clean surface.

BanerjeeBanerjee A., et al. A., et al. J Dent 2000;28(3):179J Dent 2000;28(3):179--186186

Ericson D., et al. Ericson D., et al. Caries Res 1999;33(3):171Caries Res 1999;33(3):171--7777

FureFure S., et al. S., et al. Caries Res 2000;34(3):275Caries Res 2000;34(3):275--280280

MaragakisMaragakis GM., et al. GM., et al. Caries Res 2001;35(3):205Caries Res 2001;35(3):205--210210

MunshiMunshi AK., et al. AK., et al. J J ClinClin PediatrPediatr Dent 2001;26(1):49Dent 2001;26(1):49--5454

NadanovskyNadanovsky P., et al. P., et al. Caries Res 2001;35(3):384Caries Res 2001;35(3):384--389389

SpliethSplieth C., et al. C., et al. ClinClin Oral Oral InvestigInvestig 2001 Dec;5(4):2502001 Dec;5(4):250--253253



CarisolvCarisolv®® –– the Nthe Noo 1 choice when biology is important !1 choice when biology is important !



Method Sound enamel

Sound dentine

Carious enamel

Carious dentine

Handexcavators

– – + ++

Rotary burs +++ +++ +++ +++

Air-abrasion +++ +++ ++ +

CarisolvCarisolv®® –– –– –– ++++++Lasers + + + +

Banerjee A., et al. British Dental Journal 2000;188(9):476-482.

Methods for restorative dental treatments



Intact collagenIntact collagen

Mineralized dentineMineralized dentineDemineralizedDemineralized carious dentinecarious dentine

Denatured collagenDenatured collagen

How does it work – mode of action ?

DE 2001DE 2001



CarisolvCarisolv®® applicationapplication


DE 2001DE 2001



Mechanical Mechanical

removal ofremoval of

decay.decay.

CarisolvCarisolv®® has has

““disconnecteddisconnected””

necrotic dentinenecrotic dentine

How does it work – mode of action ?Cases and product info

DE 2001DE 2001


After After CarisolvCarisolv®® applicationapplication

and after etching.and after etching.

The surface is now ready The surface is now ready

for restoration.for restoration.




Use instrument of your own choiceUse instrument of your own choice……

… just add Carisolv® for clean, safeand appropriate caries removal



1.1. 2.2. 3.3. 4.4. 5.5.

6.6.

Carisolv®

• When healthy tooth structures are precious…

• When biology is important…

• When quality counts…

• When you care about your patients…



Contact info:Contact info:

www.orasolv.sewww.orasolv.se

[email protected]@orasolv.se

+46 (0)31 74 11 780+46 (0)31 74 11 780

+46 (0)31 74 11 781+46 (0)31 74 11 781



2) Cover the cavity with gel and wait for 30 seconds until the carious tissue has been softened.

3) Softened caries can then be scraped away

1) Drilling, when the cavity needs to be opened up, for adjustment of cavity periphery and when there are large amounts of caries and the risk to affect healthy tissue is minimal.



4) Repeat without waiting 30 seconds, until the cavity is free of caries.

5) When repeating make sure cavity always well moisten with Carisolv®

3) When cariesfree – inspection and filling as usual



Take advantage of the chemistry:Take advantage of the chemistry:

•• Check if cavity caries free !Check if cavity caries free !

–– before fillingbefore filling

–– before crown cementationbefore crown cementation

–– when close to the pulpwhen close to the pulp

•• Less bleeding !Less bleeding !

•• Less pain !Less pain !

•• Less noise !Less noise !



Root surfaces

Time for excavation:Carisolv® and rotating

instruments – equal

Carisolv® less traumatic





Before cementation of permanent crownBefore cementation of permanent crown-- and bridgeworkand bridgework……

……use use CarisolvCarisolv®® to check if surface caries free !to check if surface caries free !



CarisolvCarisolv®® –– in difficult caries situationsin difficult caries situations……

CarisolvCarisolv®® –– in in

difficult caries difficult caries

situationssituations……





CarisolvCarisolv®® –– in difficult caries situationsin difficult caries situations……





































































Normal dentineNormal dentine

Necrotic dentineNecrotic dentine

Translucent dentineTranslucent dentine

Reparative dentineReparative dentine

Dental pulp chamberDental pulp chamber





Amino acidsAmino acids

CHCH22 CHCH22 CHCH22 CHCH22HH3 3 NN++

CC

HH

NHNH33

COOCOO--

++

HH

CHCH3 3

CHCH

CHCH3 3

CC

NHNH33

COOCOO--CHCH22

++

LeucineLeucine

LysineLysineHH

CC

NHNH33

COOCOO--

++

CHCH22 CHCH22

OO

O O --

CCGlutamicGlutamic acidacid



Carisolv™ gel

Singlemix

Multimix









Selection of instruments.Selection of instruments.

Start with MultiStart with Multi--Star if possible.Star if possible.



CarisolvCarisolv®® instruments instruments

are nare nonon--invasiveinvasive……

Drills and Drills and excavatorsexcavators are are

intendedintended to be to be invasiveinvasive……

Caries removalCaries removal

Ericson et al 1998Ericson et al 1998

BanerjeeBanerjee et al 2000et al 2000

CederlundCederlund et al 1999et al 1999

SpliethSplieth et al 1999et al 1999

DammaschkeDammaschke et al 2000et al 2000

HaffnerHaffner et al 2000et al 2000

Moran et al 2000Moran et al 2000

NeutschilNeutschil et al 2000et al 2000

Tonami et al 1999Tonami et al 1999

FluckigerFluckiger et al 2005et al 2005

Dentine bondingDentine bonding

HaakHaak et al 2000et al 2000

FrankenbergerFrankenberger et al 2000et al 2000

Harada et al 2000Harada et al 2000

PawlowskaPawlowska et al 2000et al 2000

SudaSuda et al 2000et al 2000

CehreliCehreli et al 2003et al 2003

Burrow et al 2003Burrow et al 2003

SonodaSonoda et al 2005et al 2005

No adverse effects dentineNo adverse effects dentine


CederlundCederlund et al 1999et al 1999

HannigHannig et al 1999et al 1999

WennerbergWennerberg et al 1999et al 1999

Pulp effectsPulp effects


Young et al 2001Young et al 2001

Hybrid layer effectsHybrid layer effects

Mason et al 1999Mason et al 1999

PerdigaoPerdigao et al 1999et al 1999

SudaSuda et al 1999et al 1999Collagen effectsCollagen effects

HannigHannig et al 1999et al 1999

JepsenJepsen et al 1999et al 1999

Tonami et al 1999Tonami et al 1999

DammaschkeDammaschke et al 1999bet al 1999b

Surface structureBanerjee et al 2000Haffner et al 2000Tonami et al 1999Arvidsson et al2002,2004

In vitro researchIn vitro research



Clinical researchClinical research

Caries removalCaries removal

Ericson et al 1999Ericson et al 1999

FureFure et al 2000,2004et al 2000,2004

BerakdarBerakdar et al 2000et al 2000

Burke et al 1999Burke et al 1999

CarneiroCarneiro et al 2000et al 2000

HaffnerHaffner et al 1999et al 1999

MasourasMasouras et al 1999et al 1999

MaragakisMaragakis et al 2000et al 2000

SongpaisanSongpaisan et al 2002et al 2002

KakabouraKakaboura et al 2003 et al 2003

KavvadiaKavvadia et al 2004et al 2004

Bergmann, Bergmann, LeitaoLeitao 20052005

Restoration survivalRestoration survival

FureFure et al 2000, 2004et al 2000, 2004

NevrinNevrin et al 1999et al 1999

Zimmerman et al 2000Zimmerman et al 2000

No adverse effectsNo adverse effects

FureFure et al 2000et al 2000

NevrinNevrin, Carlen 1999, Carlen 1999

Zimmerman et al 2000Zimmerman et al 2000

WennerbergWennerberg et al 2001et al 2001

Pulp effectsPulp effects

LumbauLumbau et al 2000et al 2000

Braun et al 2000Braun et al 2000


BulutBulut et al 2004et al 2004

Antibacterial effectsAntibacterial effects

KneistKneist et al 1999et al 1999

BaysanBaysan et al 1999et al 1999

Lager et al 2003Lager et al 2003

AzrakAzrak et al 2004et al 2004



ReviewsReviews


BeeleyBeeley et al 2000et al 2000

MaragakisMaragakis et al 2001et al 2001

Morrow et al 2000Morrow et al 2000

ZiskindZiskind et al 2005et al 2005

Review articlesReview articles



Read moreRead more……

2001 Quintessence Publishing Co. Ltd.2001 Quintessence Publishing Co. Ltd.

ISBN 1ISBN 1--8509785097--046046--77

Number of pages: 367Number of pages: 367



OraSolv AB OraSolv AB –– AttAtt: Kenneth Sternberg: Kenneth Sternberg

MedicinaregatanMedicinaregatan 8B8B

SS--413 46 413 46 GGööteborgteborg

SwedenSweden

www.orasolv.sewww.orasolv.se

[email protected]@orasolv.se

+46 (0)31 74 11 780+46 (0)31 74 11 780

+46 (0)31 74 11 781+46 (0)31 74 11 781





Clinical cases – cavities:

Step-by-step and clinical tips

Case 1 – Deep distal molar

Case 2 – Multiple cervical

Case 3 – Deep cervical

Case 4 – Small cervical

Case 5 – Wide cervical

Case 6 – Deciduous molar

Case 7 – Deep occlusal molar

Case 8 – Lingual-cervical

Case 9 – Deep mesial molar

Function of instruments

Schematic view of caries

Product information:Amino acids

Distribution systems

Start package

Instruments

Manufacturer

Distributors


Read more:Published articlesText book

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Dental caries are bacterial induced necrosis of tooth ... · Dental caries are bacterial induced necrosis of tooth structure Treatment should focus on the removal of necrotic tissue