Carisolv

Carisolv is a chemomechanical method of removing dental caries that is minimally invasive. First of all a fluid is mixed consisting of a cocktail of amino acids and 0.5% sodium hypochlorite, and is applied to the dentin. The amino acids and hypochlorite form high-pH chloramines (pH 12), which react with the denatured collagen in the carious dentin, allowing it to be removed more easily. The softened dentin is removed
by scraping the surface with special hand instruments.

This technique requires longer clinic time than similar cavity preparation employing conventional bur removal. However, because
only soft carious dentin is affected and not normal dentin, the need for anesthesia is reduced, which is a major advantage in
dental-phobic patients, children, and special needs patients.

The technique is useful for the removal of root or coronal caries where access is easily
obtained, but requires repeated application of the solution over the caries.

Use of Carisolv Gel may be an inefficient method of removing caries at the enamel-dentin junction. Carious dentin may go unnoticed beneath the overhanging enamel because ideal access may require extensive preparation with a rotary bur. However, in this region, conventional removal of caries with a bur can be demanding, even when using magnifying loops.

Kidd et al. (1989) showed that demineralized dentin remained at the enamel-dentin junction in 57% of cavities that had originally been assessed as caries-free using conventional visual and tactile means. Some bacteria will remain at the enamel-dentin junction whatever approach is adopted therefore stained, hard dentin should be left alone in this area and no attempt should be made to remove it.

Carisolv Gel removes the smear layer and has no adverse effect on the bond strength of adhesive materials to dentin. Should Carisolv come into contact with exposed pulp tissue, no toxic effect should be expected.

Clinical Studies

Young et al. (2001) found no adverse effects with Carisolv when it was left in contact with rat pulp tissue.

Bulut et al. (2004) exposed the pulp chambers of 40 human first premolars with class V cavities and applied either Carisolv or sterile saline solution for 10min. The cavities were restored with a compomer filling material and the teeth extracted after either 1 week or 1 month. No adverse histologic effects due to Carisolv were observed.

Dr. Iswarya V

Reference : Operative Dentistry – Hugh Devlin