Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial

Khalek, A. M.G. Abdul; Elkateb, Mona Abdallah; Aziz, Waseem; Tantawi, Maha El

doi:10.17796/1053-4628-41.3.219

Cited by 22 publications

(17 citation statements)

References 9 publications

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“…Two [ 26 , 27 ] included studies followed a cross-over trial design, while eighteen [ 10 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] had a split-mouth design. One study [ 45 ] followed a two parallel-arms trial, five studies [ 46 , 47 , 48 , 49 , 50 ] provided one treatment per patient while five studies [ 15 , 51 , 52 , 53 , 54 ] had one or more treatment per patient. In six studies [ 12 , 55 , 56 , 57 , 58 , 59 ] it was not possible to identify the study design, or the provided information was not enough to qualify them.…”

Section: Resultsmentioning

confidence: 99%

“…Chemomechanical versus Control [ 12 , 26 , 27 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 43 , 45 , 48 , 50 , 51 , 53 , 59 ]…”

Section: Resultsunclassified

“…Twenty-three studies [ 12 , 15 , 26 , 27 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 41 , 43 , 45 , 48 , 49 , 50 , 51 , 53 , 54 , 56 , 59 ] reporting chemo-mechanical caries removal systems were included. Two [ 43 , 49 ] involved the use of Brix 3000, three [ 35 , 36 , 50 ] the use of Carie-care, nine [ 15 , 26 , 29 , 41 , 48 , 51 , 53 , 54 , 56 ] the use of Carisolv and thirteen [ 12 , 15 , 27 , 30 , 33 , 34 , 37 , 38 , 41 , 45 , 54 , 56 , 59 ] the use of Papacarie.…”

Section: Resultsmentioning

confidence: 99%

“…The allocation concealment was not clear in 94.6% of the studies. Only two studies [ 10 , 45 ] were considered as having a low risk of selection bias in this criterion, where proper envelopes were used.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and Patient’s Acceptance of Alternative Methods for Caries Removal—A Systematic Review

Cardoso

Coelho

Lima

et al. 2020

JCM

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Dental caries is a disease of dental hard tissues, considered the most common non-communicable disease worldwide. Conventional treatments for caries removal are often associated with pain and fear, so different therapeutic approaches have been developed towards more conservative and pleasant treatments. This systematic review aimed to assess the efficacy and patient’s acceptance of alternative methods for caries removal compared to conventional methods. The Cochrane Library, Embase, Medline/Pubmed, Web of Science, and Clinical Trials databases were searched. Clinical trials of primary dental caries treated with alternative methods were included. The last search was performed on 5 August 2020. The Population, Intervention, Comparison, and Outcome (PICO) strategy was followed. Thirty-seven clinical trials were included, reporting caries removal using alternative (chemomechanical—Brix 3000, Carie-care, Carisolv and Papacarie, laser—Er:YAG (Erbium-doped Yttrium Aluminium Garnet) and Er,Cr:YSGG (Erbium, Chromium-doped Yttrium, Scandium, Gallium and Garnet), and a system combining air and sono-abrasion—Vector® System) and conventional methods. Alternative methods tended to prolong treatment time and lessen anesthesia need. All treatments were effective in reducing cariogenic flora, and the restoration’s performance did not differ significantly. Chemomechanical solutions seemed to be the best option towards minimally invasive treatments, with good control during application and action and good treatment experiences for patients. Papacarie was demonstrated to be an effective method for caries removal with less pain, and superior acceptance by patients when compared to conventional treatments.

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Section: Resultsmentioning

confidence: 99%

“…Chemomechanical versus Control [ 12 , 26 , 27 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 43 , 45 , 48 , 50 , 51 , 53 , 59 ]…”

Section: Resultsunclassified

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy and Patient’s Acceptance of Alternative Methods for Caries Removal—A Systematic Review

Cardoso

Coelho

Lima

et al. 2020

JCM

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“…Papain interacts with the exposed collagen causing the dissolution of minerals from the dentin and bacteria, thus making the infected dentin more softened, which facilitates its removal with the use of non-cutting instruments and without anesthesia and rotary instruments. 14,15 In 2012, the BRIX-3000 was released, a chemicalmechanical agent, also papain-base, with a proteolytic enzyme obtained from leaves latex and fruits of green papaya (Carica Papaya) that acts as a chemical debridant. The differential of this product according to the manufacturers is the amount of papain used (3,000 U/mg in a concentration of 10%) and the bioencapsulation thereof by EBE technology, which gives the gel the ideal pH to immobilize the enzymes and liberate them at the moment of exerting its proteolysis on the collagen.…”

Section: Introductionmentioning

confidence: 99%

Use of BRIX-3000 Enzymatic Gel in Mechanical Chemical Removal of Caries: Clinical Case Report

et al. 2018

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Less traumatic alternative methods for removal of decayed tissue has been developed. A non-invasive technique, which consists of applying a proteolytic substance that softens the infected dentin tissue and preserves healthy tooth tissue was released in the market. Thus, this work intended to describe a clinical case of caries removal using BRIX 3000 papaine-based enzymatic gel. A 6-year-old male patient attend to a Univesity Dental Clinic complaining of painful sensitivity during mastication. After examination, acute deep carious lesion was found in dental elements 64 and 65. The caries removal procedure was performed for both teeth without anesthesia, under relative isolation, following the principles of atraumatic restorative treatment - ART. The gel was taken into the cavity and leaved to act for 2 minutes and the infected tissue was excavated. Caries lesion was then detected below the OM cusp with undercut enamel, needing to enlarge the cavity in the occlusal region with rotating cutting instruments and reapply the gel. After the second application, all the infected tissue had been removed and the teeth restoration with chemical ionomer cement was performed. At the end of the treatment, the discomfort during the performed procedure was asked to the patient using the Wong-Baker Face Scale. The child pointed to score 1, indicating mild pain for both treatments. It can be concluded that the use of enzymatic papaine gel-based was an efficient alternative for caries removal, easy to use, and preserve to the maximum the dental structure healthy, showing promise to be used as atraumatic caries removal technique.Keywords: Dental Caries. Papain. Pediatric Dentistry.ResumoMétodos alternativos menos traumáticos para remoção de cárie vem sendo desenvolvidos. Uma técnica não invasiva, que consite na aplicação de uma substância proteolítica que amolece a dentina infectada e preserva o tecido dental hígido foi lançado no mercado. Sendo assim, este trabalho visa relatar um caso clínico de remoção da lesão de cárie através do gel enzimático a base de papaína, BRIX-3000. Paciente do gênero masculino, 6 anos, compareceu à Clínica Odontológica Universitária com queixa de sensibilidade dolorosa durante a mastigação. Após avaliação, constatou-se lesão cariosa profunda aguda nos elementos dentais 64 e 65. O procedimento de remoção de cárie foi realizado sem anestesia e sob isolamento relativo, seguindo os princípios do tratamento restaurador atraumático (ART). O gel foi levado à cavidade, deixado agir por 2 minutos e realizado a escavação do tecido infectado. Foi detectado lesão de cárie abaixo da cúspide OM com esmalte socavado, necessitando de ampliação da cavidade na região oclusal com instrumentos cortantes rotatórios e reaplicação do gel. Após a segunda aplicação, todo o tecido infectado foi removido e realizada a restauração dos dentes com cimento de ionômero químico. Ao final do tratamento, foi aplicado a escala de faces de Wong-Baker. A criança apontou score 1, indicando dor leve para ambos os tratamentos. Pôde se concluir que a utilização do gel enzimático a base de papaína é uma alternativa eficiente para remoção do tecido cariado, de fácil utilização, preservando ao máximo a estrutura dental sadia, sendo promissor para ser utilizado na técnica atraumática de remoção da cárie.Palavras-chave: Cárie Dentária. Papaína. Odontopediatria.

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Role of Proteolytic Enzymes in Dental Care

Pentapati

Yeturu

2020

Natural Oral Care in Dental Therapy

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Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial

Abstract: Papacarie is associated with minimal pain during caries removal from primary teeth compared to ART, although it has longer working time.

Cited by 22 publications

References 9 publications

Efficacy and Patient’s Acceptance of Alternative Methods for Caries Removal—A Systematic Review

Efficacy and Patient’s Acceptance of Alternative Methods for Caries Removal—A Systematic Review

Use of BRIX-3000 Enzymatic Gel in Mechanical Chemical Removal of Caries: Clinical Case Report

Role of Proteolytic Enzymes in Dental Care

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