Dental Caries Case Study

Dental caries is considered to be one of the most serious dental diseases that results in localized dissolution and destruction of the calcified tooth tissues. Neglecting the treatment could endanger the tooth pulp resulting in subsequent pain and tooth loss. In 1893, GV Black proposed his principle “extension for prevention” in the operative treatment of carious lesions. The fact is that the Black’s principle was constrained by both the knowledge of disease process and restorative materials presented at that time12, but the demand of removing sound enamel and dentin has been dramatically changed as a result of developing the adhesive restoratives and the alternative approaches of both caries removal and cavity preparation 13,14,15.
In the

It is available as aqua blue colored gel in a single syringe (3ml). It consists of papain, chloramines, toluidine blue dye, water, salts and thickeners. Papain is a proteolytic enzyme. It has bactericidal, bacteriostatic and anti- inflammatory characteristics. Similar to the human pepsin, papain acts as a debridant , anti- inflammatory agent which does not damage the healthy tissue and accelerates the cicatrical process.
Flindt 20 demonstrated that papain acts only in infected tissues because of absence of plasmatic anti- protease called alpha-1 anti-trypsin in infected tissues but which is present in sound tissues and it will inhibit protein digestion. The absence of alpha-1 anti-trypsin in infected tissues allows papain to break the partially degraded molecules. Toluidine blue is antimicrobial agent and water acts as a vehicle. Thus with the help of each of its constituents Papacarie achieves synergistic action that facilitates caries removal and increased anti microbial

Kidd et al. and Bjørndal et al. have reported that the number of microorganisms present and the consistency of the carious dentine are linked. They found that the number of microorganisms isolated from a site is also influenced by the method of sample taking 27. In the present study, the dentine samples were carefully removed with a sterile excavator. This method was chosen to reduce the risk of accidental pulpal exposure, especially when sampling hard dentine.
Singh et al compared the antimicrobial efficacy, efficacy in terms of time consumption and pain perception of chemomechanical caries removal agent Papacarie and conventional method of caries removal in rural population in india. They concluded that Papacarie was effective for the removal of occlusal dentinal caries in cavitated primary molars