Dental caries are bacterial induced necrosis of tooth structure

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1 Dental caries are bacterial induced necrosis of tooth structure Treatment should focus on the removal of necrotic tissue with a bacteriocidal approach.

2 Since the invention and application of rotary instruments, the operative treatment of carious lesions has often resulted in considerable removal of tooth structure. Banerjee A, Watson TF, Kidd EA. Br Dent J May 13;188(9):476-82

3 Minimally invasive dentistry focuses on preserving healthy and sound tissue. The art of intervention lies in NOT removing more than necessary.

4 In modern dentistry the primary aim when excavating carious dentin is to eradicate only the highly infected, irreversibly demineralized and denatured biomass Banerjee A, Watson TE, Kidd EA. Dent Update 2000 Jul-Aug;27(6):272-6

5 In a study aimed to evaluate the efficiency (time taken) and effectiveness (quantity of dentine removed) of carious dentine excavation bur excavation was quickest but overprepared cavities Carisolv excavation was slower but removed adequate quantities of tissue Banerjee A, Kidd EA, Watson TF. Caries Res 2000 Mar-Apr;34(2):144-50

6 Dec 2005: 62 abstract in PubMed responding to search word Carisolv! If search term chemomechanical also included, PubMed lists 91 abstracts! The Carisolv method was introduced on the market in 1997!

7 Carisolv is the best studied method for caries removal The Carisolv method was introduced on the market in 1997!

8 Carisolv removes necrotic, decayed, dentine and leaves healthy tooth structure unaffected -a minimal invasive approach when biology is an important issue. Cases and product info Arvidson A., et al. Biomaterials 2002 Oct;23(19): Banerjee A., et al. Caries Res 2000;34(2): Hanning M. Clin Oral Investig 1999;3(3):155-9 Sakoolnamarka R., et al. Aust Dent J 2002 Jun;47(2): Wennerberg A., et al. Eur J Oral Sci 1999;107(4): Yazici AR., et al. Oper Dent 2002 Jul-Aug;27(4):360-6

9 Carisolv has NO effect on sound and healthy Cases and product info dentin. Carisolv leaves a rougher dentin surface suitable for modern restauration techniques. Haak R., et al. Eur J Oral Sci 2000;108(5): Hosoya Y., et al. J Dent 2001 May;29(3): Kubo S., et al. Oper Dent 2002 Jul-Aug;27(4):387-95

10 Carisolv does not elicit adverse effect onto pulp tissue. Braun A., et al. Quintessenz 2000;51(5): Dammaschke T., et al. J Dent 2001;29(4): Dammaschke T., et al J Dent 2002 Jan;30(1):59-65 Young C., et al. J Dent 2001;29(4):

11 Clinical and histological study on oral mucosa after prolonged exposure to Carisolv did not show any inflammatory reactions. Arvidsson A., et al. Gerodontology 2001 Dec;18(2):

12 Carisolv safely and selectively removes ALL the decayed dentine leaving a caries free and clean surface. Banerjee A., et al. J Dent 2000;28(3): Ericson D., et al. Caries Res 1999;33(3): Fure S., et al. Caries Res 2000;34(3): Maragakis GM., et al. Caries Res 2001;35(3): Munshi AK., et al. J Clin Pediatr Dent 2001;26(1):49-54 Nadanovsky P., et al. Caries Res 2001;35(3): Splieth C., et al. Clin Oral Investig 2001 Dec;5(4):

13 Carisolv the N o 1 choice when biology is important!

14 Methods for restorative dental treatments Method Sound enamel Sound dentine Carious enamel Carious dentine Hand + ++ excavators Rotary burs Air-abrasion Carisolv +++ Lasers Banerjee A., et al. British Dental Journal 2000;188(9):

15 How does it work mode of action? Denatured collagen Intact collagen DE 2001 Demineralized carious dentine Mineralized dentine

16 How does it work mode of action? Carisolv application DE 2001

17 How does it work mode of action? Mechanical removal of decay. Carisolv has disconnected necrotic dentine DE 2001

18 How does it work mode of action? After Carisolv application and after etching. The surface is now ready for restoration.

19 Use instrument of your own choice Cases and product info just add Carisolv for clean, safe and appropriate caries removal 6.

20 Carisolv When healthy tooth structures are precious When biology is important When quality counts When you care about your patients

21 Contact info: (0) (0)

22 1) Drilling, when the cavity needs to be opened up, for adjustment of cavity periphery and when there are large amounts of caries and the risk to affect healthy tissue is minimal. 2) Cover the cavity with gel and wait for 30 seconds until the carious tissue has been softened. 3) Softened caries can then be scraped away

23 4) Repeat without waiting 30 seconds, until the cavity is free of caries. 5) When repeating make sure cavity always well moisten with Carisolv 3) When cariesfree inspection and filling as usual

24 Take advantage of the chemistry: Check if cavity caries free! before filling before crown cementation when close to the pulp Less bleeding! Less pain! Less noise!

25 Root surfaces Time for excavation: Carisolv and rotating instruments equal Carisolv less traumatic

26 Before cementation of permanent crown- and bridgework use Carisolv to check if surface caries free!

27 Carisolv in difficult caries situations

28 Carisolv in difficult caries situations

29 Carisolv in difficult caries situations

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64 Normal dentine Cases and product info Necrotic dentine Translucent dentine Reparative dentine Dental pulp chamber

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66 Amino acids Cases and product info CH 3 CH CH 2 H C COO - Leucine CH 3 NH 3 + H O - O C CH 2 H 3 N + CH 2 CH 2 H C CH 2 NH 3 + CH 2 COO - CH 2 C NH 3 + Glutamic acid COO - Lysine

67 Carisolv gel Singlemix Multimix

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70 Selection of instruments. Start with Multi-Star if possible.

71 Carisolv instruments are nonn on-invasive Drills and excavators are intended to be invasive

72 In vitro research Cases and product info Caries removal Ericson et al 1998 Banerjee et al 2000 Cederlund et al 1999 Splieth et al 1999 Dammaschke et al 2000 Haffner et al 2000 Moran et al 2000 Neutschil et al 2000 Tonami et al 1999 Fluckiger et al 2005 Collagen effects Hannig et al 1999 Jepsen et al 1999 Tonami et al 1999 Dammaschke et al 1999b No adverse effects dentine Banerjee et al 2000 Cederlund et al 1999 Hannig et al 1999 Wennerberg et al 1999 Surface structure Banerjee et al 2000 Haffner et al 2000 Tonami et al 1999 Arvidsson et al2002,2004 Dentine bonding Haak et al 2000 Frankenberger et al 2000 Harada et al 2000 Pawlowska et al 2000 Suda et al 2000 Cehreli et al 2003 Burrow et al 2003 Sonoda et al 2005 Hybrid layer effects Mason et al 1999 Perdigao et al 1999 Suda et al 1999 Pulp effects Dammaschke et al 2001 Young et al 2001

73 Clinical research Cases and product info Caries removal Ericson et al 1999 Fure et al 2000,2004 Berakdar et al 2000 Burke et al 1999 Carneiro et al 2000 Haffner et al 1999 Masouras et al 1999 Maragakis et al 2000 Songpaisan et al 2002 Kakaboura et al 2003 Kavvadia et al 2004 Bergmann, Leitao 2005 Restoration survival Fure et al 2000, 2004 Nevrin et al 1999 Zimmerman et al 2000 No adverse effects Fure et al 2000 Nevrin,, Carlen 1999 Zimmerman et al 2000 Wennerberg et al 2001 Antibacterial effects Kneist et al 1999 Baysan et al 1999 Lager et al 2003 Azrak et al 2004 Pulp effects Lumbau et al 2000 Braun et al 2000 Dammaschke et al 2001 Bulut et al 2004

74 Review articles Cases and product info Reviews Banerjee et al 2000 Beeley et al 2000 Maragakis et al 2001 Morrow et al 2000 Ziskind et al 2005

75 Read more 2001 Quintessence Publishing Co. Ltd. ISBN Number of pages: 367

76 OraSolv AB Att: : Kenneth Sternberg Medicinaregatan 8B S Göteborg Sweden info@orasolv.se +46 (0) (0)

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78 Clinical cases cavities: Step-by-step and clinical tips Case 1 Deep distal molar Case 2 Multiple cervical Case 3 Deep cervical Case 4 Small cervical Case 5 Wide cervical Product information: Amino acids Distribution systems Start package Instruments Manufacturer Distributors Case 6 Deciduous molar Case 7 Deep occlusal molar Case 8 Lingual-cervical Case 9 Deep mesial molar Function of instruments Read more: Published articles Text book Schematic view of caries Back to start