Journal of South Asian Association of Pediatric Dentistry

Register      Login

VOLUME 5 , ISSUE 3 ( September-December, 2022 ) > List of Articles


Efficacy of Papain Gel—A Smart Alternative to Conventional Methods of Carious Dentin Removal: An In Vitro Study

Malay Mitra, Rahul Kaul, Dempsy MM Chengappa

Keywords : Chemomechanical, Conventional caries removal, Papacarie, Papain gel

Citation Information : Mitra M, Kaul R, Chengappa DM. Efficacy of Papain Gel—A Smart Alternative to Conventional Methods of Carious Dentin Removal: An In Vitro Study. J South Asian Assoc Pediatr Dent 2022; 5 (3):152-156.

DOI: 10.5005/jp-journals-10077-3247

License: CC BY-NC 4.0

Published Online: 27-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: The study was aimed at finding out the efficacy of the caries removal ability of a chemomechanical agent (papain gel) and comparing it with that of conventional slow-speed rotary carbide burs and mechanical hand excavators in deciduous extracted molars. Materials and methods: A total of 30 extracted teeth that were used for the present study were distributed equally among two major categories (15 each) by simple random sampling technique. The teeth were sectioned into two halves mesiodistally in a longitudinal plane through the center of the caries. In each category, the corresponding halves were sectioned off randomly but in equal numbers further into two groups as follows: Category 1: Group I hand excavators and group II carbide burs. Category 2: Group III hand excavator group and group IV Papacarie group. Parameters recorded included total time taken for caries removal and residual caries remaining using caries detection dye in each group and category, which were estimated and observed under a stereomicroscope (magnification 12.5×). The data was computed and statistically analyzed to find out and compare the efficacy of caries removal of three different methods used. Results: As per the critical difference (CD), the results of the study showed the caries removal mean time for group IV (Papacarie group) when compared to other groups was significantly higher (p < 0.01). Group II had a significantly lower mean time than the other groups (p < 0.01). Results also showed group II had a significantly lower mean area of residual caries than the other groups (p < 0.01). A significantly lower mean of residual caries was found in group IV than that in group I and group III (p < 0.05). Conclusion: From the results of this study, it was found that papain gel can be used as an effective alternative method compared to conventional methods for caries removal, especially in pediatric patients, owing to its lesser time commitment and better outcome.

  1. Allen KL, Salgado TL, Janal MN, et al. Removing carious dentin using a polymer instrument without anesthesia versus a carbide bur with anesthesia. J Am Dent Assoc 2005;136(5):643–650. DOI: 10.14219/jada.archive.2005.0237
  2. Roberson T, Heymann H, Swift E. Sturdevant's Art and Science of Operative Dentistry, 4th ed. Elsevier: Mosby, 2004;330.
  3. Silva NRFA, Carvalho RM, Tay FR. Evaluation of a self-limiting concept in dentinal caries removal. J Dent Res 2006;85(3):282–286. DOI: 10.1177/154405910608500315
  4. Fusayama T. Two layers of carious dentin: diagnosis and treatment. Oper Dent 1979;4(2):63–70. PMID: 296808.
  5. Tassery H, Levallois B, Terrer E, et al. Use of new minimum intervention dentistry technologies in caries management. Aust Dent J 2013;58(1):40–59. DOI: 10.1111/adj.12049
  6. Yamada Y, Hossain M, Shimizu Y, et al. Analysis of surface roughness and microleakage of fissure sealants following organic debris removal with Carisolv. J Dent 2008;36(2):130–137. DOI: 10.1016/j.jdent.2007.11.009
  7. Looze Y, Boussard P, Huet J, et al. Purification and characterization of a wound-inducible thaumatin-like protein from the latex of Carica papaya. Phytochemistry 2009;70(8):970–997. DOI: 10.1016/j.phytochem.2009.05.005
  8. CDC guidelines for infection control in dental health-care settings – 2003. MMWR 2003;52(No. RR-17):1–66. Available at: pdf icon [PDF-1.2 M]. Accessed March 17, 2021
  9. de Almeida SM, Franca FM, Florio FM, et al. Analysis of total microbiota in dentin after mechanical or papain-based chemomechanical caries removal. Gen Dent 2013;61(4):59–63. PMID: 23823347.
  10. Asociación Latinoamericana de Odontopediatría, Equipo Interdisciplinario COVID-19. Caries disease treatment during COVID-19: clinical protocols for aerosol control. Rev Odotopediatr Latinoam 2020;10(2):183–219.
  11. Frankenberger R, Van Meerbeek B. Editorial: choosing wisely - it is time for dentistry. J Adhes Dent 2018;20(3):179. DOI: 10.3290/j.jad.a40765
  12. Ganesh M, Parikh D. Chemomechanical caries removal (CMCR) agents: review and clinical application in primary teeth. J Dent Oral Hyg 2011;3(3):34–45.
  13. Manton DJ. Diagnosis of the early carious lesion. Aus Dent J 2013;58(Suppl 1):35–39. DOI: 10.1111/adj.12048
  14. Dammaschke T, Eickmeier M, Schafer E, et al. Effectivenesss of carisolv compared with sodium hypochlorite and calcium hydroxide. Acta Odonto Scand 2005; 63(2):110–114. DOI: 10.1080/00016350510019810
  15. El-Tekeya M, El-Habashy L, Mokhles N, et al. Effectiveness of 2 chemomechanical caries removal methods on residual bacteria in dentin of primary teeth. Pediatr Dent 2012;34(4):325–330.
  16. Konde S, Urs P, Raj S. Efficacy of Papacarie in caries removal: an in vivo study. W Dent 2011;2(3):183–186. DOI: 10.5005/jp-journals-10015-1080
  17. Ericson D, Zimmerman M, Raber H, et al. Clinical evaluation of efficacy and safety of a new method for chemo-mechanical removal of caries. A multi-centre study. Caries Res 1999;33(3):171–177. DOI: 10.1159/000016513
  18. Nadanovsky P, Cohen Carneiro F, Souza de Mello F. Removal of caries using only hand instruments: a comparison of mechanical and chemomechanical methods. Caries Res 2001;35(5):384–389. DOI: 10.1159/000047478
  19. Kotb RM, Abdella AA, El Kateb MA, et al. Clinical evaluation of Papacarie in primary teeth. J Clin Pediatr Dent 2009;34(2):117–124. DOI: 10.17796/jcpd.34.2.f312p36g18463716
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.