MINIMAL INTERVENTION DENTISTRY by Mehta Mitesh & Patel Benil
Author:Mehta, Mitesh & Patel, Benil
Language: eng
Format: epub
Published: 2020-06-06T00:00:00+00:00
Reagent used in caries chemo mechanical removal:
GK-101 [NMG]:
It consists of N-mono chloroglycine [NMG] and sodium hypochlorite.
NMG was initially on bovine Achilles tendon collagen by Kzonman et al. The author exposed the tendon to deionize water & buffer the two NMG solutions for 2,15and 30 min in a 37°C water bath. SEM evaluation showed minimal effect on the collagen fibrils in an ionized water and NMG solution caused varying degree of degradation.
GK 101 proved to be too slow in caries removal rate and in subsequent studies it was found that the system was more effective if glycine was replaced by amino butyric acid. Monochloro amino butyric acid [NMAB] is designed as GK 101 E. 39
GK 101 E [NMAB]:
It received FDA acceptance in 1894, the commercial product is known Caridex .it consists of N-monochloro âDL-2 amino butyric acid.
It consist of 2 solutions --solution 1 containing sodium hypochlorite and solution 2 containing glycine, amino butyric acid ,sodium chlorite and sodium hydroxide .The solutions are mixed just before use to give the working reagent, which is stable for 1 hour ,pH approximate 11.
A delivery system is available which consists of a reservoir for the solution, a heater and a pump which passed the liquid warmed to body temperature through a tube to hand pieces and an applicator tip, which is available in various shapes & size.
The solution was applied to the carious lesion by means of applicator which was used to loosen the carious dentine by a gentle scraping action, the debris together with the solution being removed by aspiration. Application was continued until dentine remaining was deemed sound by normal clinical tactile criteria. It requires 5-10 minutes to remove the carious dentine.39
Caries removal by GK 101& GK 101E:
According to kuroski et al GK 101 solution soften only the first [infected] layer of the carious dentine .They found GK 101 to soften the outer dentinal caries by 2-19 Knoop hardness number in all teeth .They presumed the softening to be due to selective attack of the solution specially on degenerated collagen fibres, with out affecting the sound fibres the inner layer and the normal dentine underneath. According to another SEM study by GOLMAN et al NMAB removes the entire decayed dentine [both layer] leaving the surface of sound dentine. In removing dentine caries using 37 teeth treated with system for a maximum of the 30 minutes.
Histological examination of the cavity floor was found to be clinically caries free only in 5.4% .There were no teeth in which the enamel âdentine interface was free caries free. Based on these finding, the author concluded that caridex system did not produce adequate result.
Histological evaluations performed by scheutzel showed that 90% cavities treated with caridex system were found to have residual decay. In 77% of the total cavities remaining bacteria were observed. Caries removal efficacy was improved with combined use of caridex & spoon excavator.40
Addition of urea:
An attempt was made to improve the reagent by addition of urea, which normally denatures protein by breaking down hydrogen bonding, thereby making them more stable.
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