This document discusses chemomechanical caries removal (CMCR), a non-invasive technique that uses a chemical agent to dissolve infected dentin. It originated in the 1970s using sodium hypochlorite to remove organic materials from root canals. Later products like Caridex and Cariosolve were developed using amino acids that selectively dissolve demineralized dentin while preserving healthy tissue. Cariosolve uses sodium hypochlorite and three amino acids in two syringes. It has advantages like less pain, tissue preservation, and suitability for uncooperative patients. However, it may still require instruments and can be time-consuming.

1. Cariosolve
DR.Junait Othman
Mosul university- College of
dentistry

2. Defenition
 Chemomechanical caries removal
(CMCR)
 is a non-invasive technique eliminating
infected dentine via a chemical agent.
This is a method of caries removal based
on dissolution.

3. History
 The idea developed in 1970 while using
NaOCl in endodontic treatment.
 NaOcl is able to remove the organic
materials in the root canals and dissolve
the carious dentine tissues.
 (Goldman and Kronman1976)
GK101only attack the degenerated
collagen fibers and soften the inner layer
of carious dentine then instrument is used.

4.  Caridex 1984 two bottle system
1. NaoCl
2. glycine, aminobutyric acid, sodium
chloride and sodium hydroxide.
3. Disadvantage
the large volumes of liquid used per cavity
preparation and the increased time
equired

5. Cariosolve 2009
 It makes use of three naturally occurring
amino acids (glutamic acid, leucin and
lycine) .
 Composed of two syringe
1. sodium hypochlorite (0.5%)
2. glutamic
acid, lysine, leucine, carboxymethylcellul
ose, sodium chloride, sodium hydroxide
and a red dye.

6. Mechanism of action
 causes proteolytic degradation of the
already partially broken-down collagen in
the outer carious dentine.
 followed by the removal of lesion using
specially designed non-invasive
instrument. This procedure is repeated
until all carious tissues are removed.

7. advantages

8. 1. ability of selectively removing the outer layer of dentin
caries.
2. it does not attack the sound dentin as it is alkaline
3. Over-excavation of the cavity, thereby, is prevented.
4. Less perception of pain and more comfortable for
patient.
5. Less fear and anxiety to method, leads to less
discomfort to patients especially in children.
6. Removes only infected layer and leads to more tissue
preservation.
7. No pulpal irritation.
8. Well suited to the treatment of deciduous teeth, dental
phobic’s and medically compromised patients.
9. Better removal of caries in uncooperative patients.
10. Useful in physically handicapped patients.
11. Useful in patients with T.B like infectious diseases
(prevent droplet infection).

9. Disadvantages
1. Rotary and/or hand instruments may still be
needed for the removal of tissue Large volumes
of solution were needed (200 to 500 ml) and the
procedure was slow and also costly.
2. Only certain cavities were suitable for treatment
by the technique and because of the time
involved (10 to 15 min) and limited use, its
popularity waned.
3. Although there were studies on the efficacy of
caries removal by the procedure, studies on the
long term success of cavities restored after
CMCR treatment were lacking.


10. How to use it in clinic
1. Apply the gel with one of the hand
instruments.
2. Wait 30sec
3. Remove carious dentine with hand
instrument.
4. Reapt the procedure until no more
carios dentine is left.