title: Efficacy and tolerance of papain gel with conventional drilling method: a clinico-microbiological study.
abstract: BACKGROUND
  Conventional methods of caries removal are commonly associated with pain, fear and discomfort. Chemomechanical methods were introduced to instill a positive dental attitude. Agents like GK-101, Caridex, Carisolv did not prove effective alternatives owing to their high cost, need of special instruments and taste of chlorine. A new chemomechanical agent, Papacarie®, has been introduced to overcome these deficiencies.
  
  
  OBJECTIVE
  This study was aimed to compare the effectiveness and tolerance of Papacárie® with the conventional method.
  
  
  METHODS
  25 children with at least two primary teeth with broad cavitated occlusal or cervical lesion were selected. One carious tooth from each patient was randomly treated with each of Papacarie® and conventional drilling method, one after the other. Time taken for caries excavation, child's pain perception, change in anxiety levels, microbial flora and child's preference of treatment were recorded separately for both the methods.
  
  
  RESULTS
  Although the mean time taken for caries removal by the Papacarie® method was slightly longer (P≯0.05) but it led to reduction in pain and anxiety (p<0.05). The viable bacterial counts were significantly reduced by either of the two methods (P <0�0001). More patients preferred Papacarie® over conventional method of treatment (P<0.05).
  
  
  CONCLUSIONS
  Papacárie® method seems to be a better alternative to conventional method of caries removal.
authors.forename: P A
authors.initials: PA
authors.lastname: Goyal
authors.forename: R
authors.initials: R
authors.lastname: Kumari
authors.forename: V P
authors.initials: VP
authors.lastname: Kannan
authors.forename: S
authors.initials: S
authors.lastname: Madhu
mesh_terms: D058491:Bacterial Load / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D016854:Dental Anxiety / Q000523:psychology; D003731:Dental Caries / Q000382:microbiology / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000379:methods*; D005260:Female; D005782:Gels; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects; D008297:Male; D010092:Oximetry / Q000379:methods; D058748:Pain Perception / Q000502:physiology; D010206:Papain / Q000008:administration & dosage / Q000627:therapeutic use*; D057240:Patient Preference; D013291:Streptococcus / Q000187:drug effects; D013997:Time Factors; D014094:Tooth, Deciduous / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D005782:Gels; C509557:Papacarie; D010206:Papain
keywords: Caries; Chemomechanical caries removal; Conventional method; Papacarie®