Article Data

  • Views 467
  • Dowloads 169

Original Research

Open Access

Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study

  • Nikita Gupta1,†
  • Nikhil Marwah1,†
  • Anant Nigam1
  • Satish Vishwanathaiah2,†
  • Noura Alessa3
  • Asma Almeslet4
  • Khalid Alhakami5
  • Tazeen Dawood6
  • Feras Majed Masha7
  • Prabahdevi C Maganur2,*,†,

1Department of pedodontics and preventive dentistry, Mahatma Gandhi Dental college and hospital, 302022 Jaipur, India

2Department of preventive dental sciences, Division of pediatric dentistry, College of Dentistry, Jazan University, 45142 Jazan, Saudi Arabia

3Department of pediatric dentistry and orthodontics, Dental college, King Saud University, 11545 Riyadh, Saudi Arabia

4Department of Oral maxillofacial surgery and diagnostic sciences, College of Medicine and Dentistry, Riyadh Elm University, 12734 Riyadh, Saudi Arabia

5King Abdulaziz medical city of national guard health affairs, 21423 Jeddah, Saudi Arabia

6Department of Preventive dental sciences, Division of periodontics, College of Dentistry, Jazan university, 45142 Jazan, Saudi Arabia

7The middle sector, Ministry of Health, General Directorate for Health, 84211 Jazan, Saudi Arabia

DOI: 10.22514/jocpd.2024.066 Vol.48,Issue 3,May 2024 pp.131-138

Submitted: 25 August 2023 Accepted: 30 October 2023

Published: 03 May 2024

*Corresponding Author(s): Prabahdevi C Maganur E-mail: cgowda@jazanu.edu.sa

† These authors contributed equally.

Abstract

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.


Keywords

BRIX3000™; Carie-Care™; Chemomechanical caries removal; Pain perception; Papacarie®


Cite and Share

Nikita Gupta,Nikhil Marwah,Anant Nigam,Satish Vishwanathaiah,Noura Alessa,Asma Almeslet,Khalid Alhakami,Tazeen Dawood,Feras Majed Masha,Prabahdevi C Maganur. Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study. Journal of Clinical Pediatric Dentistry. 2024. 48(3);131-138.

References

[1] Cardoso M, Coelho A, Lima R, Amaro I, Paula A, Marto CM, et al. Efficacy and patient’s acceptance of alternative methods for caries removal—a systematic review. Journal of Clinical Medicine. 2020; 9: 3407.

[2] Nagaveni N, Radhika N, Satisha T, Ashwini K, Neni S, Gupta S. Efficacy of new chemomechanical caries removal agent compared with conventional method in primary teeth: an in vivo study. International Journal of Oral Health Sciences. 2016; 6: 52.

[3] Campbell SD, Cooper L, Craddock H, Hyde TP, Nattress B, Pavitt SH, et al. Removable partial dentures: the clinical need for innovation. The Journal of Prosthetic Dentistry. 2017; 118: 273–280.

[4] Bussadori Sk, Castro LC, Galvao AC. Papain gel: a new chemo-mechanical caries removal agent. Journal of clinical pediatric dentistry. 2005; 30: 115–119.

[5] Senthilkumar V, Ramesh S. Systematic review on alternative methods for caries removal in permanent teeth. Journal of conservative dentistry. 2020; 23: 2–9.

[6] Shashikala, Krishnamoorthy SH, Savithasathyaprasad, George J. Carie care’ a novel method of caries removal & its effectiveness: a randomised clinical trial. International Journal of Development Research. 2017; 1: 17899–17902.

[7] Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: a randomized controlled clinical trial. Journal of Dentistry. 2020; 93: 103280.

[8] Gulzar S, Arora R, Shah AH, Bhardwaj B, Abusalim G, Khalil HS, et al. Antibacterial activity of two chemomechanical caries removal gels on carious dentin of primary teeth: an in vitro study. The Journal of Contemporary Dental Practice. 2016; 17: 1027–1032.

[9] Choudhary K, Gouraha A, Sharma M, Sharma P, Tiwari M, Chouksey A. Clinical and microbiological evaluation of the chemomechanical caries removal agents in primary molars. Cureus. 2022; 14: e31422.

[10] Almaz ME, Sonmez LS, Oba AA. Comparison of chemomechanical caries removal using Papacarie versus conventional method in children. European Journal of General Dentistry. 2016; 51: 1–5.

[11] Anegundi RT, Patil SB, Tegginmani V, Shetty SD. A comparative microbiological study to assess caries excavation by conventional rotary method and a chemo-mechanical method. Contemporary Clinical Dentistry. 2012; 3: 388–392.

[12] Hegde S, Kakti A, Bolar DR, Bhaskar SA. Clinical efficiency of three caries removal systems: rotary excavation, carisolv, and papacarie. Journal of Dentistry for Children. 2016; 83: 22–28.

[13] Matsumoto SF, Motta LJ, Alfaya TA, Guedes CC, Fernandes KP, Bussadori SK. Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial. Indian Journal of Dental Research. 2013; 24: 488–492.

[14] Motta LJ, Bussadori SK, Campanelli AP, Silva AL, Alfaya TA, Godoy CH, et al. Randomized controlled clinical trial of long-term chemo-mechanical caries removal using Papacarie™ gel. Journal of Applied Oral Science. 2014; 22: 307–313.

[15] Goyal PA, Kumari R, Kannan VP, Madhu S. Efficacy and tolerance of papain gel with conventional drilling method: a clinico-microbiological study. Journal of Clinical Pediatric Dentistry. 2015; 39:109–112.

[16] Hamama HH, Yiu CK, Burrow MF, King NM. Chemical, morphological and microhardness changes of dentine after chemomechanical caries removal. Australian Dental Journal. 2013; 58: 283–292.

[17] Hegde AM, Preethi VC, Shetty A, Shetty S. Clinical evaluation of chemomechanical caries removal using Carie-Care system among school children. Journal of Health and Allied Sciences NU. 2014; 3: 80–84.

[18] Hegde RJ, Chaudhari S. Comparative evaluation of mechanical and chemo-mechanical methods of caries excavation; An in vivo study. Journal of International Oral Health. 2016; 8: 357–361.

[19] Nagaveni NB, Radhika NB, Satisha T, Ashwini KS, Neni S, Gupta S. Efficacy of new chemomechanical caries removal agent compared with conventional method in primary teeth: an in vivo study. International Journal of Oral Health Sciences. 2016; 6: 52.

[20 Nalawade Harsha, Lele G, Walimbe H. Comparative evaluation of efficacy of chemomechanical and conventional methods of caries excavation in young permanent molar teeth: in vivo study. Journal of Dental Research and Review. 2019; 6: 13–18.

[21] AlHumaid J. Efficacy and efficiency of papacarie versus conventional method in caries removal in primary teeth: an SEM study. Saudi Journal of Medicine & Medical Sciences. 2020; 8: 41–45.

[22] Sontakke P, Jain P, Patil AD, Biswas G, Yadav P, Makkar DK, et al. A comparative study of the clinical efficiency of chemomechanical caries removal using Carie-Care gel for permanent teeth of children of age group of 12–15 years with that of conventional drilling method: a randomized controlled trial. Dental Research Journal. 2019; 16: 42–46.

[23] Balachandran J, Raees T, Rao M. Jayachandran C. Evaluation of efficacy of chemo-mechanical method of caries removal using Brix-3000 compared to conventional excavation with burs—a randomized controlled trial. Journal of Indian Dental Association. 2020; 14: 12–18.

[24] Eftimoska M, Petroska A, Terzievski B, Rendzova V, Apostolska S. Comparative study of caries removal using BRIX 3000 and classic mechanical method. Serbian Dental Journal. 2022; 69: 57–65.

[25] Meyfarth S, Cassano K, Warol F, de Deus Santos M, Scarparo A. A new efficient agent to chemomechanical caries removal. Brazilian Dental Journal. 2020; 77: e1946–e1950.

[26] Ansari G, Beeley JA, Fung DE. Chemomechanical caries removal in primary teeth in groups of anxious children. Journal of Oral Rehabilitation. 2003; 30: 773–779.

[27] Banerjee A, Watson TF, Kidd EA. Dentine caries excavation: a review of current clinical techniques. Br Dent J. 2000; 188: 476–82.

[28] Appukuttan DP. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clinical, Cosmetic and Investigational Dentistry. 2016; 8: 35–50.

[29] Ericson D, Zimmerman M, Raber H, Götrick B, Bornstein R, Thorell J. Clinical evaluation of efficacy and safety of a new method for chemo-mechanical removal of caries. A multi-centre study. Caries Research. 1999; 33: 171–177.

[30] Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatric Nursing. 1988; 14: 9–17.

[31] Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatric Nursing. 1997; 23: 293–297.

[32] Maashi MS, Elkhodary HM, Alamoudi NM, Bamashmous NO. Chemomechanical caries removal methods: a literature review. The Saudi Dental Journal. 2023; 35: 233–243.

[33] Dogra M, Gupta MP, Sheikh T, Nirmala H, Bhardwaj A, Juntavee A. Stop drill, make a change: an in vivo study. International Journal of Clinical Pediatric Dentistry. 2021; 14: 258–262.

[34] Aswathi KK, Rani SP, Athimuthu A, Prasanna P, Patil P, Deepali KJ. Comparison of efficacy of caries removal using polymer bur and chemomechanical caries removal agent: a clinical and microbiological assessment—an in vivo study. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2017; 35: 6–13.

[35] Deng Y, Feng G, Hu B, Kuang Y, Song J. Effects of Papacarie on children with dental caries in primary teeth: a systematic review and meta-analysis. International Journal of Paediatric Dentistry. 2018; 28: 361–372.

[36] Ismail MM, Haidar A. Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city. Journal of Baghdad College of Dentistry. 2019; 31: 7–13.

[37] Kotb RM, Abdella AA, El Kateb MA, Ahmed AM. Clinical evaluation of Papacarie in primary teeth. Journal of Clinical Pediatric Dentistry. 2009; 34: 117–123.

[38] Kochhar GK, Srivastava N, Pandit IK, Gugnani N, Gupta M. An evaluation of different caries removal techniques in primary teeth: a comparative clinical study. Journal of Clinical Pediatric Dentistry. 2011; 36: 5–9.

[39] Boob AR, Manjula M, Reddy ER, Srilaxmi N, Rani T. Evaluation of the efficiency and effectiveness of three minimally invasive methods of caries removal: an in vitro study. International Journal of Clinical Pediatric Dentistry. 2014; 7: 11–18.

[40] Felizardo KR, Barradas NP, Guedes GF, Ferreira FD, Lopes MB. Use of BRIX-3000 enzymatic gel in mechanical chemical removal of caries: clinical case report. Journal of Health Sciences. 2018; 20: 87.

[41] Prabhav C, Anuja M, Garima C. Chemomechanical caries removal with Brix 3000 in primary molar tooth: a case report. International Journal of Current Medical and Pharmaceutical Research. 2019; 5: 4740–4742.

[42] Oommen SR, George L, Mathew J, RV V, Paul S. Assessment of pain response during caries removal using conventional tungsten carbide bur and a chemomechanical caries removal agent (Brix Gel): an in vivo study. Journal of Indian Dental Association. 2021; 15: 21–27.

[43] Santos TML, Bresciani E, Matos FS, Camargo SEA, Hidalgo APT, Rivera LML, et al. Comparison between conventional and chemomechanical approaches for the removal of carious dentin: an in vitro study. Scientific Reports. 2020; 10: 8127.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top