Chemomechanical caries removal: a comprehensive review of the literature

Compared to the past, caries removal has become more efficient, however inh erent fundamental drawbacks of the drilling approach have remained: unpleas antness to patients, need for local anesthesia, and potential adverse effec ts to the pulp due to heat and pressure. Chemomechanical caries removal, in troduced almost three decades ago, was claimed to be a non-invasive alterna tive for the removal of carious dentine. In essence, the technique involved applying a solution onto the decayed dentinal tissue, allowing it to softe n it, and, finally, scraping it off with blunt hand instruments. The partia lly degraded collagen in carious dentine was chlorinated by chemomechanical caries removal solutions. This chlorination affected the secondary and/or quaternary structure of collagen, by disrupting hydrogen bonding. Carious m aterial removal was thus facilitated. The purpose of this paper is to perfo rm a comprehensive review of the literature regarding chemomechanical carie s removal, including the most recently available product, the initial repor ts on which warrant renewed interest in the approach.