A clinical and microbiological assessment of the efficacy of chemo-mechanical caries removal versus conventional caries removal methods in children: a randomized controlled clinical trial

Background: Effective caries removal in pediatric dentistry is vital for reducing discomfort and maintaining oral health. Traditional methods like drilling can be invasive, prompting interest in alternatives such as the chemo-mechanical caries removal method. Aim: This study aimed to compare the efficacy, pain and satisfaction, treatment time, and microbiological outcomes of a sodium hypochlorite-based chemo-mechanical caries removal method (CarieMove® Gel) with conventional drilling in pediatric patients. Methods: A randomized controlled clinical trial involved 30 children aged 7-9 years with a bilateral class 1 caries in first permanent molars, as per the International Caries Detection and Assessment System (ICDAS)No 4, with no pulp involvement. CarieMove® Gel was randomly applied to one side for caries removal, while the conventional drilling method was used on the other side. Caries removal efficacy, pain and satisfaction, caries excavation time and microbial presence before and after treatment were registered. Data were collected, and tabulated statiscally analyzed at a 5% significance level (p ≤0.05). Results: Comparative analysis showed similar overall efficacy between the chemo-mechanical and conventional methods, with no significant difference (p=0.083). Pain and patient satisfaction pain perception were significantly higher with the chemo-mechanical method (p<0.001), despite a longer treatment time (p<0.001). Microbiological evaluations revealed no significant difference in bacterial count between the two methods (p=0.893). Conclusion: This study highlighted the efficacy and acceptability of CarieMove® Gel as a promising alternative to traditional drilling for caries removal in pediatric patients. While both methods were effective, CarieMove® Gel resulted in a higher patient satisfaction. Although treatment time was slightly longer, the increased comfort and positive experiences suggest its value for young children. Received: 09 August 2024 Accepted: 31 October 2024 Published: 19 November 2024