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Selective caries removal (Chemo-mechanical)

Evidence based Compendium. Selective caries removal (Chemo-mechanical). Minimally Invasive Treatment Selective caries removal (chemo-mechanical). Is patient comfort after chemo-mechanical caries removal really higher as compared to conventional drilling ?. Minimally Invasive Treatment

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Selective caries removal (Chemo-mechanical)

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  1. Evidence based Compendium Selective caries removal (Chemo-mechanical) www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  2. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Is patient comfort after chemo-mechanical caries removal really higher as compared to conventional drilling ? www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  3. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Chemical composition of active agent Erythrosine: Red dye Sodiumhypochloride Carboxyl-methyl-cellulose: Gel former/base 3 Aminoacids: Glutamate, Lysine, Leucine www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  4. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Composition of dentine fibres 1 Collagen Fiber = 1 collagen fiber consisting of triple helices TRIPLE HELICES ARE INTERCONNECTED BY COVALENT CROSS LINKS www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  5. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Composition of dentine fibres (2) = 3 Peptide chains Hydrogenbonds • 1 triple helix consists of 3 peptide chains • Peptide chains are interconnected by hydrogen bonds 1 Triple helix www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  6. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Composition of dentine fibres (3) 1 Peptide chain = Single Peptides Peptidebonds • 1 peptide chain consists of peptides • Peptides are interconnected by peptide bonds www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  7. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Chemo-mechanical action: Electrostatic splitting • Acts only on non-covalent links of collagen structures after exposure through bacterial enzymes • Bacterial enzymes split covalent cross links through proteolysis Peptide bonds Act! COVALENT CROSS LINKS Hydrogenbonds Not! Act! www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  8. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Review date: 5 July 2005 Articles relevant = 15 Articles rejected = 11 Articles accepted = 4 Location of Accepted trials Sweden (3) Canada Iceland Denmark (2) The Netherlands (3) Sweden (2) UK (2) Germany Japan USA France Hungary Greece Israel India UK Greece Brazil (3) South Africa (3) www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  9. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Applied exclusion criteria: forTherapy trials and Systematic reviews Exclusion criteria for Reviews: 1. Focus on population or intervention is not clearly stated in title and abstract 2. Article methodology describes no clear inclusion and exclusion criteria for reviewed publications 3. Article methodology describes no clear search strategy, key words and used databases and includes no study-by-study critique table or discussion of study qualities www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  10. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Exclusion criteria for Trials: 1. No control group exists; 2. The study and control group compared are not similar; 3. The exposure and outcomes are not measured the same way in the compared groups; 4. Exposure does not precede outcome; 5. The study shows no clear dosage-response relationship. www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  11. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Number of excluded reviews = 11 Reasons of exclusion: No clear exclusion and/or inclusion criteria stated; Lack of information on clear search strategy, key words and databases used; study-by-study critique table missing Number of excluded trials = 4 Reasons of exclusion: Not truly randomly controlled www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  12. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) Number of accepted articles = 4 For value scale of evidence rating see MI Compendium, Chapter 5: http://www.midentistry.com/academia.html www.midentistry.com/academia.html --- (c) midentistry cc, 2006

  13. Minimally Invasive Treatment Selective caries removal (chemo-mechanical) The evidence suggests that chemo-mechanical caries removal ensures higher patient comfort then conventional drilling. www.midentistry.com/academia.html --- (c) midentistry cc, 2006

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