Papain-based gel for biochemical caries removal: influence on microtensile bond strength to dentin

Abstract

This study investigated the influence of a papain-based gel (Papacárie) for chemo-mechanical caries removal on bond strength to dentin. Human molars were assigned to the following groups: Group 1: sound teeth were flattened to expose dentin; Group 2: after flattening of surfaces, the papain-based gel was applied on the sound dentin; Group 3: overlying enamel from carious teeth was removed and mechanical excavation of dentin was conducted; Group 4: chemo-mechanical excavation of carious dentin was conducted using the papain-based gel. The Prime&Bond NT or Clearfil SE Bond adhesive systems were used for restorative procedures. A microtensile bond strength test was performed, and the modes of failure were determined under SEM. The data were submitted to two-way ANOVA and Tukey's test (p < or = 0.05). No significant differences were observed between the sound dentin groups. For both excavation methods, Clearfil presented a significantly higher bond strength than Prime&Bond NT. Also, for Clearfil, the mechanically excavated samples disclosed a significantly higher bond strength than the chemo-mechanically ones. For Prime&Bond NT, no significant differences were detected between the excavation methods. Predominance of mixed failures for the sound substrate and of adhesive failures for the carious dentin one was detected. The bond strength to carious dentin of the self-etching system was negatively affected by chemo-mechanical excavation using the papain-based gel.

Alternative Caries Removal Methods

“…36 Papain, kollajen molekülleri kısmen degrade olmuş olan ve normalde sağlıklı dokularda sindirim görevini inhibe eden α1-anti-tripsin enziminin eksikliğinden dolayı özellikle enfekte ve ölü dokuları parçala-maktadır. 37 Bu sebeple Papacarie, sağlıklı dentinde minimal hasara yol açacak şekilde çürük dentinin uzaklaştırılmasına olanak tanımaktadır. 38 Biosolv (SFC-V and SFC-VIII, 3M -ESPE AG, Seefeld,Germany) ; Henüz deney aşamasında olan enzimatik kemomekanik çürük temizleme ajanıdır.…”

A utilização do gel de papaína na remoção de lesões cariosas dentinárias

“…Após aplicação do gel na dentina cariada, há uma formação de bolhas de oxigênio na superfície dentinária com posterior turvação do gel, indicando a quebra das moléculas de colágeno e sinalizando que se pode iniciar a remoção do tecido cariado. O aspecto vítreo do tecido dentinário no fundo da cavidade evidencia a completa remoção do tecido infectado 1,6,7,10,11,14,15,21,26,27,30,31,3 3, 34,35,36 .…”

“…Depois da mudança de coloração do gel, a dentina amolecida cariada e infectada deve ser raspada com instrumento manual sem corte (parte inativa da cureta). Pereira et al 30 23,35,37 . O uso de adesivo autocondicionante, que não utiliza o condicionamento ácido, exerce maior interferência na polimerização do sistema adesivo.…”

Effect of Papain gel on Orthodontic Bracket Bonding: A Comparative Study

“…16 It is a proteolytic cysteine enzyme with antibacterial and antiinflammatory properties, and it acts as an agent for removing debris without any harmful effect on tissues because of the specificity of the enzyme. 17,18 It is used with the aim of removing infected tissue without causing any damage to any healthy structure in the mouth, and requires neither instruments with cutting edges nor rotary instruments.…”