Oral Health and Dental Management

Abstract

Clinical Evaluation of a Papain-Based Gel for the Chemo-Mechanical Removal of Caries in Children

Lumbini Pathivada, Munagala Karthik Krishna, Mehak Kalra, Gopinath Vivekanandan, Jaspal Singh, Saumya Navit

Aim: To evaluate and compare the efficacy and acceptability of a papain based chemomechanical caries removal gel, Carie-care, against Carisolv gel and conventional air-rotor cavity preparation. Study design: This study was designed as a split-mouth, randomized controlled trial with three treatments being compared in the same subject. Materials and Methods: The study was conducted on 30 children in the age group of 8-15yrs, each having at least three permanent molar teeth with non-pulpally involved carious lesions. Each of the three teeth was randomly assigned to be treated with either Carie-care, Carisolv or high-speed cavity excavation with air-rotor. The following assessments were made for each tooth: efficacy of caries removal, cavity entrance size, cavity preparation time, pain during treatment, requirement for local anesthesia and degree of patient co-operation. Statistical Analysis: Within group and between group variances amongst the study groups were analyzed with parametric (ANOVA) and non-paramaetric (Kruskall WallisH test) methods. Students 't' test was used to test the significance of two means. Results: The rate of complete caries removal was highest in airrotor group (86.7%) and least in Carisolv group (66.7%). No changes in cavity entrance size pre- and posttreatment were observed in the CMCR groups whereas a significant increase in cavity entrance size was observed (0.65 ± 0.55) in airrotor treated teeth. Mean values of time taken for procedure were 5:38 ± 0:30(SD) mm:ss and 5:50 ± 0:27(SD) mm:ss 0:58 ± 0:09(SD) mm:ss for Carie-care, Carisolv and airrotor, respectively. None of the patients treated with Carie-care had reported pain. In Carisolv and airrotor groups, mean values of pain scores were 0.2 ± 0.41 and 1.33 ± 0.55, respectively. Patients treated with CMCR gels did not request for local anesthesia but 8 (26.7%) of airrotor treated patients had required LA. The mean value for Frankl behavior rating scale was higher for CMCR groups (3.53 ± 0.51) as compared to that for the traditional method (2.43 ± 0.50). Conclusion: Based on the results of this study, the CMCR methods were less invasive and painful and more acceptable for patients as compared to the conventional method. The only observed drawback with these methods was the lengthy procedure time. Between the two CMCR gels, Carie-care was observed to be less painful and marginally less time-consuming.