title: Clinical and microbiological evaluation of the carious dentin before and after application of Papacarie gel.
abstract: OBJECTIVE
  To evaluate clinically and microbiologically the efficacy of Papacarie in the removal of carious dentin in both permanent and primary teeth.
  
  
  METHODS
  Thirty permanent and primary molars with dentinal carious lesions were excavated and subjected to clinical and microbiological assessment before and after application of Papacarie. The gel was further tested for in vitro antimicrobial efficacy against standard cariogenic micro-organisms using agar diffusion assay.
  
  
  RESULTS
  Papacarie was able to differentiate between infected and affected dentin clinically along with high patient comfort during caries excavation. The mean time taken for caries removal and restoration was observed to be 4.17 +/- 0.40 min. and 8.57 +/- 0.45 min. for permanent teeth and 4.21 +/- 0.36 min. and 9.24 +/- 0.58 min. for primary teeth. There was a significant reduction in the total viable colony forming units from the dentin samples before and after application of Papacarie. It was also observed that Papacarie had no inhibitory effect on standard cariogenic microorganisms in the agar diffusion assay.
  
  
  CONCLUSIONS
  Papacarie is an effective caries removal method clinically in both permanent and primary teeth. The number of viable microorganisms after complete caries excavation using Papacarie still appears to be high and this bacterial count should be tackled by a suitable restorative material with potent antimicrobial activity.
authors.forename: Swarnika
authors.initials: S
authors.lastname: Gupta
authors.forename: Chanchal
authors.initials: C
authors.lastname: Singh
authors.forename: Ramakrishna
authors.initials: R
authors.lastname: Yeluri
authors.forename: Kalpna
authors.initials: K
authors.lastname: Chaudhry
authors.forename: Autar Krishen
authors.initials: AK
authors.lastname: Munshi
mesh_terms: D016924:Actinomyces viscosus / Q000187:drug effects / Q000302:isolation & purification; D000890:Anti-Infective Agents / Q000494:pharmacology; D058491:Bacterial Load / Q000187:drug effects; D002648:Child; D003731:Dental Caries / Q000382:microbiology / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000379:methods*; D003793:Dental Restoration, Permanent / Q000379:methods; D003804:Dentin / Q000382:microbiology / Q000473:pathology*; D005782:Gels; D006801:Humans; D007780:Lacticaseibacillus casei / Q000187:drug effects / Q000302:isolation & purification; D008963:Molar / Q000382:microbiology / Q000473:pathology*; D010147:Pain Measurement; D010206:Papain / Q000494:pharmacology / Q000627:therapeutic use*; D013295:Streptococcus mutans / Q000187:drug effects / Q000302:isolation & purification; D013997:Time Factors; D014094:Tooth, Deciduous / Q000382:microbiology / Q000473:pathology
chemical_list: D000890:Anti-Infective Agents; D005782:Gels; C509557:Papacarie; D010206:Papain