Carisolv is a chemomechanical method for removing dental caries. For this purpose, the caries is exposed to a gel with special chemical components for a certain exposure time and then removed with the help of a blunt hand instrument.
Dentin (tooth bone) consists of a hard tissue component embedded in a collagen framework. Dental caries, in turn, is composed of two different zones: the outer zone, in which the hard tissue is dissolved and the collagen framework is destroyed, and the inner zone adjacent to the healthy dentin, in which demineralization (dissolution of the hard tissue) may already have occurred due to the metabolic products of the bacteria causing the caries, but in which hardly any bacteria are found. For this reason, the collagen framework is still preserved here. This can be remineralized (hard substance can be stored again).
The Carisolv method takes advantage of the difference between intact and destroyed collagen framework. The gel attacks only the already weakened areas of the collagen framework, while the collagen in the inner demineralized zone of the carious defect is preserved.
Indications (areas of application)
The standard of excavation (removal of dentin caries) is mechanical removal by a slowly rotating rose bur. Since the dentin is connected to the pulp (innervated dental pulp) via the dentin tubules, the typical pain sensation during preparation (drilling) is caused by pressure, heat or cold with appropriate water cooling. These pain sensations are not transmitted during the removal of dental caries pre-treated with Carisolv. Thus, the following indications result:
- Excavation in patients in whom especially the drilling noises cause anxiety.
- Excavation in patients who cannot be locally anesthetized (locally anesthetized) due to their anxiety.
- Excavation in patients where local anesthesia should be avoided due to pre-existing conditions.
The method
The Carisolv- method has in common with conventional excavation (removal of dental caries) that first must be prepared (drilled) with rapidly rotating instruments such as diamond-coated abrasives to remove the enamel layer covering the carious defect. This is only followed by the actual Carisolv procedure:
- Mixing of two liquid components immediately before application. The solutions consist of amino acids, dye and sodium hydroxide and sodium hypochlorite, among other things; by the latter two components, the mixture reacts strongly alkaline (basic).
- Reaction time: collagen dissolution targeted in the dentin layer pre-damaged by caries bacteria.
- Removal of the pre-treated layer by means of a special hand instrument with comparatively blunt lamellae as working surfaces. Thus, a scraping rather than a cutting excavation takes place. The excavation is done substance gently related to the preservable demineralized, but remineralizable dentin of the defect.
The serious disadvantage of the procedure is that the caries removal takes much more time than the conventional excavation with a slowly rotating instrument. However, the time window available for the treatment is particularly narrow in the target group of anxiety patients, so that there is a risk that the treatment cannot be satisfactorily completed due to decreasing compliance (cooperation). This can probably be seen as the main reason why the procedure does not belong to the routine treatment among the excavation methods.
