Atraumatic restorative treatment and Carisolv use for root caries in the elderly: 2-year follow-up randomized clinical trial

New preventive and treatment strategies are required to address the high prevalence of caries among the elderly. The main objective of this study was to analyze the effectiveness of CarisolvA (R) gel to improve the clinical behavior of restorations obtained by atraumatic restorative treatment (ART) in root caries of elderly patients. A secondary objective was to determine the factors associated with the failure of ART restorations after a 2-year follow up. A randomized controlled trial with 2-year follow-up was designed for this purpose. Candidate caries lesions were randomly assigned to an ART group for root caries treatment with the conventional ART technique, filling with glass ionomer, or an ART + CarisolvA (R) gel for the same ART plus the application of a caries solvent (CarisolvA (R)). Evaluations were conducted at 6, 12, and 24 months. A total of 81 restorations were performed, 37 in the ART group and 44 in the ART + CarisolvA (R) gel group, with 22 and 26 restorations, respectively, surviving at the end of the 24-month follow-up. Survival rates at 24 months did not significantly differ between ART (63 %) and ART + CarisolvA (R) gel (62 %) restorations. The best model for predicting the failure of the restorations included the number of tooth-brushings/day, the presence or not of prosthesis, the anterior or posterior location of the tooth, and the baseline plaque level. The application of Carisolv does not modify the survival rate of ART restorations in elderly patients. The use of Carisolv gel does not improve the outcomes of atraumatic restorative treatment.