Caries-removal effectiveness of a papain-based chemo-mechanical agent: A quantitative micro-CT study

Area of Science:

• Dentistry
• Biomaterials
• Dental Caries Research

Background:

• Dental caries management often involves removing decayed tooth structure.
• Chemo-mechanical caries removal aims for selective removal of infected dentin.
• Papain-based agents offer a potential alternative for caries excavation.

Purpose of the Study:

• To assess the effectiveness and specificity of a papain-based chemo-mechanical agent.
• To quantify residual caries after using the papain-based gel.
• To evaluate the agent's ability to selectively remove carious dentin.

Main Methods:

• Extracted carious molars were analyzed using micro-computed tomography (micro-CT) before and after treatment.
• Dentin substrate was classified by mineral density, establishing a caries threshold.
• Volumetric parameters assessed effectiveness (removed dentin volume, residual tissue) and specificity (caries removal accuracy).

Main Results:

• The papain-based gel generally removed dentin volume similar to or greater than initial caries volume.
• High accuracy in caries removal correlated with removal of caries-affected tissue.
• Residual dentin consistently met or exceeded the mineral density threshold for carious dentin.

Conclusions:

• The papain-based gel demonstrated effectiveness in removing carious dentin in vitro.
• The agent achieved removal up to a conservative threshold.
• Factors like lesion activity and enamel morphology may impact the agent's performance.