Palabras clave
Caries dental; Agentes químicos; Tratamiento restaurativo atraumático; Técnica dental de alta velocidad.
Cómo citar
Resumen
Esta revisión sistemática tuvo como propósito comparar la eficacia y la eficiencia de los agentes químico-mecánicos (AQM) frente al sistema rotatorio (SR) para la remoción de caries dental (CD) en molares permanentes. La búsqueda se realizó en cinco bases de datos electrónica (PubMed, Ebsco, Scopus, ScienceDirect, LILACS) y literatura gris, complementada con búsqueda manual en revistas de impacto, hasta julio de 2022 en idioma inglés, español y portugués. La eficacia del tratamiento de CD se analizó de forma histológica, microbiológica, radiográfica o fisicoquímico-mecánicas y la eficiencia según el menor tiempo para la remoción. El riesgo de sesgo se evaluó con la herramienta RoB. De 914 publicaciones, se incluyeron 9 estudios que evaluaron 337 molares con diseño partido tratados con SR de baja o alta velocidad y AQM, como Carisolv, Papacarie, Carie Care y Brix 3000. Más estudios demostraron diferencias significativas (p<0,05) donde Carisolv tuvo mayor cantidad de caries residual, presencia de bacterias en dentina y menor extensión o volumen de caries eliminada, mientras que Papacarie mostró ausencia de barrillo dentinario en túbulos dentinarios y SR obtuvo mayores valores de microdureza y requirió menor tiempo para la remoción. No hubo diferencias entre ambos métodos respecto a valoración de calcio y fósforo o la resistencia a la unión (p≥0,05). Los AQM eliminaron la DC con menos invasión de los tejidos de dentina sanos en comparación con el RS, pero aminoraron la dureza de la superficie y requirieron un tiempo de eliminación más prolongado.
Citas
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