Carisolv化学机械去腐技术的临床应用评价

Clinical evaluation of caries removal with a chemo-mechanical Carisolv method

目的：临床比较和评价Carisolv化学机械去腐技术和慢速球钻在乳牙龋齿去腐应用中的效率及被患儿接受的程度。方法：选择年龄6～9岁、有对称的乳牙中龋或者深龋的32名儿童，采用自身半口对照，分别用Carisolv和球钻去腐并树脂充填，记录去腐时间；问卷调查患者对2种方法的接受程度；6个月后复查充填体的情况。结果：在均未使用局部麻醉的情况下，Carisolv去腐时间较球钻长[分别是（4．33±1．25）min、（2．58±0．82）min]（P〈0．0001）。78％的患儿认为Carisolv去腐时疼痛轻于球钻；97％的患儿认为Carisolv凝胶的味道可接受，多数患儿倾向于使用Carisolv去腐。6个月后的复查表明Carisolv和球钻去腐后的充填体在微隙、继发龋率及脱落率方面差异无显著性。结论：Carisolv去腐时患儿的疼痛程度明显减轻，但去腐时间较球钻稍长。与球钻去腐相比多数患儿倾向于Carisolv。Carisolv去腐不增加充填体的微隙形成和继发龋率。

Objective：To compare the caries removal efficiency of Carisolv with that of drilling in deciduous teeth. Methods：Thirty-two children,aged from 6 to 9 years, with symmetric coronal medium or deep caries in deciduous teeth,were involved in the clinical study. According to a split-mouth design, in each patient, caries tissue was removed by using a round bur on one side, and Carisolv on the other side. After caries removal, the teeth were restored with composite resin. Patients were asked to fill in a postoperative questionnaire, including patient acceptance of technique preference. 6 months after operation the restorations were checked. Results： The time （ min ） for Carisolv caries removal and for drilling method were 4.33 ± 1.25 and 2.58 ± 0.82 respectively（ P 〈 0. 0001 ）. The patients felt more painful （78%） in the operation by drilling than by Carisolv （9%）. 97% patients accepted the taste of Carisolv gel. The majority of patients preferred Carisolv to bur. In 6-month follow-up, there was no significant difference in the incidence of marginal microleakage, secondary caries and restoration lost between Carisolv and drilling treatment（ P 〉 0.05 ）. Conclusion ： Carisolv is a time-consuming technique, but the majority of patients accepte Carisolv because of less pain. Carisolv may have no effect on the incidence of marginal microleakage and secondary caries.