Evaluation of Pepsin Enzyme-based Gel efficacy in Chemomechanical caries removal (CMCR) comparing with Carisolv (A Clinical Controlled Randomized Study)

Abstract

Background & Aim: Traditional caries removal methods were associated with many problems, such as pulp overheating, need for local anesthesia and patient discomfort. So restorative dentistry focused on searching for new ways to remove caries, as chemomechanical caries removal method is considered a convenient and alternative method to the traditional method.

The aim of this study is to evaluate the effectiveness of a new pepsin enzyme-based gel compared with Carisolv as a chemomechanical caries removal agent on primary anterior teeth.

Materials and Methods: A split mouth, randomized controlled clinical study on 40 primary anterior teeth of children aged 4-7 years, each child having at least two symmetrical vestibular carious lesions on the anterior teeth. Pepsin-based gel and Carisolv solution were applied to carious lesions until complete removal of the caries, evaluating the effectiveness of both agents was evaluated. Also, pain and discomfort during therapeutic procedures and the need for local anesthesia were assessed. The Mann-Whitney U test was used to study the differences in the degree of pain and discomfort and the chi-square test was used to study the differences in the need for local anesthesia between pepsin enzyme - based gel  group and Carisolv group at the 95% confidence level and P < 0.05.

Results: Results showed that there were no statistically significant differences in the effectiveness of caries removal (100% for both substances), as well as  in the degree of pain and discomfort, and the need for local anesthesia between pepsin enzyme - based gel  group and Carisolv group were not significant  (P = 0.861, P = 0.548, respectively).

Conclusions: Pepsin enzyme -based gel could be considered as similar to Carisolv solution in terms of efficacy, pain level reduce, and the need for local anesthesia administration as a chemomechanical caries removal agent for small carious lesions on primary anterior teeth in children 4-7 years old.