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

Recent paradigm  shift in restorative dentistry emphasizes the need of minimal intervention and maximum conservation of tooth structure while treating carious lesions . Chemomechanical caries removal (CMCR) is one of the developing treatment modalities in the field of minimally invasive dentistry involving the application of a chemical solution to the carious dentine thus enabling the exclusive removal of carious tissue in the demineralized zone and preserving the underlying sound dentin . A plethora of CMCR methods have been experimented and developed over the years. Early studies involved using a solution, GK-101, containing the active ingredient, N-monochloroglycine (NMG)  Later, the GK101 system was modified by replacing the glycine with aminobutyric acid (N monochloro- D-2 aminobutyrate) for the purpose of enhancing its efficacy (GK101E), commercially introduced in the early eighties as a two-bottle system, called Caridex  Several clinical trials showed a high rate acceptability and preference of Caridex . Continuous attempts to improve the product resulted in the development of CarisolvTM (MediTeam, Sweden), a gel-based system that can be applied with specially designed hand instruments Recently, PapacarieTM (Formula Eacao, Brazil) was introduced which owes its proteolytic action to papain, a unique endoprotein extracted from the papaya fruit. One of the recent entrants in CMCR is Carie-careTM, developed by Uni BioTech Pharma and the Vittal Mallya Scientific Research Foundation, India (Figure 1). Similar to Papacarie, this blue coloured gel consists of papain as its main ingredient. In addition, the preparation contains clove oil, an antiinflammatory and analgesic essential oil, chloramines and dye. Till-date, limited research has been performed for determining the suitability of this product for the purpose of CMCR . The aim of the present study was to evaluate the efficacy and acceptability of Carie-care in comparison with another gel formulation and conventional high-speed cavity preparation.

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