CHEMICOMECHANICAL CARIES REMOVAL (CARISOLV)

CARIDEX

The chemo-mechanical system for caries removal was published in 1975 by HABIB et al.

It is marketed under the trade name of Caridex.

Chemo-mechanical caries removal uses sodium hypochlorite (NaOCl), a non-specific proteolytic
agent (monoaminobutyric acid) removing organic components at room temperature


CARISOLV

Carisolv consists of a red gel and transperant fluid.

composition

Red gel
glutamic acid,
leucin,
lysine,
sodium chloride,
erythrosine,
water and sodium hydroxide

Transparent fluid
0.5% sodium hypochlorite


The chemical action of Carisolv is similar to that of Caridex in softening the carious dentin but leaving the healthy dentin unaffected

In caridex it was shown that, NaOCl was dissolving not only necrotic tissue but also sound dentin.

INSTRUMENTS
Special instruments designed to scrape in two or in several directions, which reduce the friction during caries excavation

MECHANISM OF ACTION

While mixing amino acids react with sodium hypochloride and forms chloromines.

chloromines seems to involve the chlorination of partially degraded collagen and the conversion of hydroxyproline to pyrrole-2-carboxylic acid, which initiates disruption of altered collagen fibres in carious dentin .

ACTION OF FLUORIDE ON TEETH

ACTION OF FLUORIDE ON TEETH

It is deposited on the enamel by the formation of a globular deposits of CaF2.

These globules do not dissolve as quickly as expected on their basis of their solubility.

The solubility is attributed to prescence of phosphate and proteins rich surface covering these globules.

The dissolution of fluoride from globules is pH dependent,because phosphate ions are released when they are protonated at low pH.

During a cariogenic challenge, F released from this globules may diffuse into the enamel promoting reformation of apatite.

It is known that the formation of the CaF2 reservoir is increased under acidic compared to neutral condition.

Fluoride from saliva or exogenous sources such as fluoride rinses, gels, varnishes and toothpastes is taken up preferentially by biofilms, lessens the effects of an acidogenic challenge and facilitates remineralization when the resting pH returns to 7.0.

INCREASED CONCENTRATION

Increased concentrations of calcium and phosphate in biofilms, saliva and artificial calcifying fluids, excessive levels of fluoride lead to rapid mineral precipitation on the enamel surface and owing to occlusion of surface porosities communicating with the subsurface leads to white-spots.

So that high concentration topical fluoride results in unsightly white opacification of enamel lesions.

High frequency application of low F concentration agents has been considered the most beneficial treatment regime.

journal of de n t i s t r y, 2 0 0 8

Adv Dent Res ,1994