Study of different micro-minimally invasive techniques in treatment of elderly root caries
CHEN Fei1, XUE Peng1, LUO Qiang1, CHU Deqin2, JIA Tingting1, WANG Lin1, CHU Bingfeng1
1. Department of Stomatology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; 2. Department of Stomatology, Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force, Hefei 230041, China
Abstract：Objective To evaluate the clinical effect of atraumatic restorative treatment (ART), Carisolv Ⅲ chemo-mechanical excavation, ultrasonic excavation and conventional excavation with handpieces & burs combined with dental operating microscope on elderly root caries by removal efficiency, pain degree and filling effect. Methods A total of 277 patients (315 teeth) aged 60 and above diagnosed with root caries in the department of stomatology of our hospital from December 2019 to August 2021 were numbered according to the order of visits and randomly divided into 4 groups using the random number table method: 69 patients (79 teeth) in Group A (the ART group), 67 patients (76 teeth) in Group B (the Carisolv Ⅲ group), 72 patients (83 teeth) in Group C (the ultrasonic group C), and 69 patients (77 teeth) in Group D (the conventional group). After removal of the caries by each minimally invasive technique and conventional excavation combined with dental operating microscope, the cavities were filled with Fuji Glass ionomer cement in group A and 3M composite resin in other three groups. The caries-removal time and patient self-assessment of pain by Visual Analogue Score in each group were recorded. All patients received specific oral health instruction. The follow-up was conducted 3 months, 6 months and 12 months and the clinical evaluations of restorations were carried out in accordance with modified USPHS/Ryge clinical evaluation criteria. Results The caries-removal time was Group B[(5.1±1.7) min]> Group A [(4.9±1.6) min]>Group C [(4.5±1.2) min]> D group [(3.9±1.3) min], difference between Group A and Group B, Group A and Group C was found to be statistically insignificant, but there were statistical differences among the other groups (P<0.05). Pain rate (mild and moderate pain) ranked as Group B (17.91%) < Group A (26.09%) < Group C (40.28%) < D group (76.81%), differences between all the minimally invasive technique groups (A, B, C) and conventional group (Group D) were statistically significant (P<0.05), the pain rate was also statistically less in Group B than Group C (P< 0.05). There were no statistical differences in the survival of restorations, marginal adaptation, marginal staining, secondary caries, gingival inflammation and pulp reaction among all groups at the same period, also within group at different period. Conclusions The application of ART, Carisolv Ⅲ chemo-mechanical excavation and ultrasonic excavation combined with dental operating microscope on elderly root caries can achieve satisfactory clinical effect without significant difference except that the caries-removal time are longer than that of conventional excavation with handpieces & burs. Meanwhile, the patients suffer less pain perception during operation. These micro-minimally invasive techniques can give consideration to the clinical effect and comfort of elderly patients with root caries, and are worthy of clinical promotion.
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2023, Vol. 34 
