Patient comfort after chemo-mechanical caries removal - a systematic review

Purpose: To appraise patient comfort after chemo-mechanical caries removal as compared to conventional drilling. Methods: 9 anglo- and 2 lusophone databases were search using English and Portuguese key words ( 5 July 2005). Relevant articles in English, German, Portuguese and Spanish were included for further review. Trials were excluded on lack of randomization, control group, blinding and baseline data; drop out rate > 33%; no statistical adjustment of baseline differences and no assessment of clinically important outcomes. Reviews were excluded if information on article selection criteria, search strategy, key words, searched databases and study-by-study critique tables were missing. In case of multiple reports from the same study, the report of the longest period was included. Two reviewers independently reviewed articles and extracted information. Accepted articles were assessed to be of ‘Reasonable' , ‘Good' or Strong' quality.

Results:136 articles were identified of which 15 were judged to be relevant. 11 articles (7 reviews and 4 trials) were subsequently excluded. All 4 accepted articles demonstrated trials of good quality and reported higher patient comfort after chemo-mechanical caries removal then after drilling. 3 trials followed parallel group- and 1 trial followed a modified split mouth design. The genders of patients were equally distributed in all trials and the age of patients ranged from 3-85 years. Conclusion: The evidence suggests that chemo-mechanical caries removal ensures higher patient comfort than conventional drilling.