Evaluation of caries removal using papain versus conventional bur in primary teeth

Introduction Conventional treatments for caries removal in children are often associated with pain and fear, so chemomechanical caries removal agents as Brix 3000 have been developed as one of minimally invasive technique which consists of applying a proteolytic substance that only softens the infected dentin tissue and preserves healthy tooth tissue providing more comfortable, and conservative treatment. Objectives The aim of this study was to evaluate the clinical efficacy of papain compared to the conventional bur preparation in caries removal in primary teeth. Patients and methods A randomized controlled clinical trial with sample consisted of 30 healthy children aged from 4 to 7 years old. On 60 bilaterally cavitated primary molars, a split mouth approach was used, where caries excavation was carried out with Brix 3000 on one side and traditional burs on the other. The variables evaluated were pain response, the average treatment time needed and Streptococcus mutans and Lactobacillus counts before and after caries removal. Results Regarding pain response, there was a statistically significant difference between the two techniques, however Brix 3000's caries removal time was significantly longer than the bur's. S. mutans and Lactobacillus counts were reduced using each of the methods, and a statistically significant difference was found; however, the reduction was slightly greater using the chemomechanical method than the conventional method, but this difference was not statistically significant. Conclusions Brix 3000 is an efficient alternative for caries removal in primary teeth with no pain and great microbiological efficacy, however it requires longer time.