Comparative evaluation of the efficiency of caries removal using various minimally invasive techniques with conventional rotary instruments using cone beam computed tomography: An in vitro study

Aim: The aim of this in vitro investigation was to assess the most efficient minimally invasive technique (MIT) by comparing the change in volume after caries removal using cone beam computed tomography (CBCT) and the time taken for each technique. Materials and Methods: Forty human extracted molars, stored in 0.1% thymol solution, with carious lesions extending into the dentin were used in the study. The caries status of dentin was judged initially by visual inspection and probing and confirmed by caries detector dye. A pre-scan CBCT was performed before assessing the volume of the carious lesion. Teeth were assigned into four groups (n = 10): Group 1 = Carisolv gel, Group 2 = Carie Care, Group 3 = ultrasonic tips, and Group 4 = slow-speed rotary instruments. The caries removal was performed according to the manufacturer's instructions. Time taken was recorded for each method. A postoperative scan was conducted, and volumetric analysis was carried out. The amount of removal of sound tooth structure was assessed to determine the most MIT. Descriptive and inferential statistics were used to analyze the data. The intergroup volume change of caries was carried out using the Kruskal-Wallis test, whereas comparison within the group was carried out using Wilcoxon signed-rank test. The assessment of time taken during each procedure was analyzed with one-way analysis of variance and Tukey honest significant difference test. The results were tabulated accordingly. Significance was set at P value ≤ 0.05. Results: The chemomechanical agents (Carisolv and Carie Care) showed minimal change in volume when compared to conventional diamond points. The time taken with conventional diamond point was minimum, and it was maximum for ultrasonic tips. Conclusion: Chemomechanical caries removal is the most minimalistic approach when compared to the other techniques.