In vitro evaluation of five alternative methods of carious dentine excavation

This in vitro, split-tooth study aimed to evaluate the efficiency (time tak en) and effectiveness (quantity of dentine removed) of four techniques of c arious dentine excavation (bur, air-abrasion, sono-abrasion and Carisolv(TM ) gel) compared to conventional hand excavation. Eighty freshly extracted h uman molars were assigned to four experimental groups (n = 20), sectioned l ongitudinally through occlusal lesions and pre-excavation colour photomicro graphs obtained. Using the natural autofluorescence of carious dentine (det ected using confocal laser scanning microscopy) as an objective and reprodu cible guide, carious dentine removal was assessed in each half of the split tooth sample, comparing hand excavation to the test method. The time taken to reach a cavity floor that was hard to a dental probe was noted and fina l colour photomicrographs were taken. From the results, it was concluded th at bur excavation was quickest but overprepared cavities relative to the au tofluorescent signature, whereas Carisolv excavation was slowest but remove d adequate quantities of tissue. Sono-abrasion tended to underprepare where as air-abrasion was more comparable to hand excavation in both the time and amounts of dentine removed. Conventional hand excavation appeared to offer the best combination of efficiency and effectiveness for carious dentine e xcavation within the parameters used in this study. Copyright (C) 2000 S. K arger AG, Basel.