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.
Introduction: The foundation of minimally invasive dentistry
is based on caries removal techniques that preserve as many healthy teeth as
possible. Because of this, the current goal of operating on carious dentine is
to stop the carious lesion's growth and provide a solid foundation for
restorative dentistry by removing only soft, diseased tissue. Chemomechanical
caries excavation is a great illustration of a conservative caries eradication
technique. This technique preserves a larger thickness of caries-affected
dentine (CAD) while removing only the infected dentine. On the same principle,
this study was conducted to compare the effectiveness of papain gel, a
chemico-mechanical agent, in removing dental cavities to mechanical hand
excavators and traditional slow-speed rotating carbide burs.
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 meantime 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 in Group I and Group III (p <
0.05). The duration of treatment is often a challenge in treating pediatric
dental; this can be a potential limitation. However, in a clinical situation,
the difference in time consumption between papain gel, hand excavator, and
carbide bur may be less because papain gel and a hand excavator usually do not
require local anesthesia, thus reducing the actual operative period.
Conclusion: It is concluded 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. This study can be further supported by microbiological
validation to find the proportion of bacteria in the residual carious dentin
after excavation and their significance.
Please see the book here:- https://doi.org/10.9734/bpi/mria/v11/1655
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