Caries removal efficiency and minimally invasive potential of SmartPrep burs, Brix 3000, and excavus: A micro-computed tomography comparative study
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Background: Thisstudy compared caries removal efficiency (CRE) and minimally invasive potential (MIP) of four excavation techniques – SmartPrep polymer burs, Brix 3000 chemo-mechanical gel, Excavus sonic system, and tungsten carbide burs (control) – using micro-computed tomography volumetric analysis in deep cavitated molars. Materials and Methods: Twenty extracted human permanent molars with deep Class I carious lesions were bisected (= 40 halves, 10/group), scanned preexcavation (Skyscan 1172/1176, 14.6 μm voxel), excavated per standardized protocols, and re-scanned postexcavation. CRE assessed residual caries volume/initial caries volume ratio (RC/IC) and cavity floor mineral density (MD). MIP measured relative cavity enlargement. One-way analysis of variance with Bonferroni post hoc determined intergroup differences (< 0.05; SPSS v26.0). Results: Significant differences were observed among the groups for both CRE and minimally invasive potential (MIP) (P < 0.001). The control group (tungsten carbide bur) demonstrated the highest CRE, with the lowest residual caries ratio (RC/IC: 0.0264 ± 0.00083) and highest MD (1.2631 ± 0.06351 g/cm). Among the minimally invasive techniques, Excavus showed superior CRE (RC/IC: 0.1976 ± 0.00888; MD: 0.8634 ± 0.06145 g/cm), followed by Brix 3000 (0.2604 ± 0.03542; 0.683 ± 0.0362 g/cm), whereas SmartPrep exhibited the lowest CRE (0.6396 ± 0.00766; 0.4813 ± 0.0287 g/cm). In contrast, SmartPrep demonstrated the highest MIP (greatest tissue pr
Abstract
Background: Thisstudy compared caries removal efficiency (CRE) and minimally invasive potential (MIP) of four excavation techniques – SmartPrep polymer burs, Brix 3000 chemo-mechanical gel, Excavus sonic system, and tungsten carbide burs (control) – using micro-computed tomography volumetric analysis in deep cavitated molars. Materials and Methods: Twenty extracted human permanent molars with deep Class I carious lesions were bisected (= 40 halves, 10/group), scanned preexcavation (Skyscan 1172/1176, 14.6 μm voxel), excavated per standardized protocols, and re-scanned postexcavation. CRE assessed residual caries volume/initial caries volume ratio (RC/IC) and cavity floor mineral density (MD). MIP measured relative cavity enlargement. One-way analysis of variance with Bonferroni post hoc determined intergroup differences (< 0.05; SPSS v26.0). Results: Significant differences were observed among the groups for both CRE and minimally invasive potential (MIP) (P < 0.001). The control group (tungsten carbide bur) demonstrated the highest CRE, with the lowest residual caries ratio (RC/IC: 0.0264 ± 0.00083) and highest MD (1.2631 ± 0.06351 g/cm). Among the minimally invasive techniques, Excavus showed superior CRE (RC/IC: 0.1976 ± 0.00888; MD: 0.8634 ± 0.06145 g/cm), followed by Brix 3000 (0.2604 ± 0.03542; 0.683 ± 0.0362 g/cm), whereas SmartPrep exhibited the lowest CRE (0.6396 ± 0.00766; 0.4813 ± 0.0287 g/cm). In contrast, SmartPrep demonstrated the highest MIP (greatest tissue preservation), followed by Brix 3000 and Excavus, whereas the control group showed the greatest cavity enlargement.analysis revealed statistically significant differences between most groups, except between SmartPrep and Excavus for CRE. Conclusion: Tungsten carbide burs provide the maximal CRE benchmark, whereas Excavus/Brix 3000 optimally balances efficacy and conservation per selective caries removal paradigms. SmartPrep prioritizes MIP but requires adjuncts for deep lesions. Findings support lesion-specific technique selection, favoring pulp preservation.