Abstract
Tooth decay is a multifactorial disease. Fermentable sugar, host factors, and cariogenic microbial flora are several agents that influence dental structure. In literature, alternative protocols for treating cavities are always of interest in terms of reducing pain and preserving tissue. In this case report, the use of a new gel-based on papain, which has a chemical effect on bacteria and allows the consistency of the altered tissue to be modified, leads to a less traumatic removal of the infected tissue. In this case report, BRIX3000, a gel with papain as its main ingredient, was used to treat an interproximal cavity on an upper premolar of a 35-year-old man frightened of the turbine. After a clinical check of all the systematic conditions and a first view of the oral cavity, the protocol was explained to the patient, and informed consent was obtained. The protocol involved applying the papain gel directly to the cavity, and after 2.5–3 minutes, it was removed. The complete removal of the infected tissue was achieved in three steps. The patient reported no discomfort, and the cavity was completely treated and ready to be restored. In conclusion, BRIX3000 seems to be a good alternative to the turbine in cavity treatment, particularly in patients who have discomfort during traditional treatments and are frightened of the turbine.
Highlights
Tooth decay is the most widespread disease in the world and has been defined by WHO as a major public health problem globally [1]
The use of a new gel-based on papain, which has a chemical effect on bacteria and allows the consistency of the altered tissue to be modified, leads to a less traumatic removal of the infected tissue
There is a progressive involvement of the dentine, and if not treated, there is an involvement of the dental pulp, and symptoms appear [1]
Summary
Tooth decay is the most widespread disease in the world and has been defined by WHO as a major public health problem globally [1]. Dental caries is a noncommunicable disease (NCD), mediated by the interaction of various factors (physical, biological, environmental, behavioural, and lifestyle-related) that combine to create a degenerative process on the tooth surface with consequent loss of minerals in the hard tissue of the tooth [3]. They lead to a loss of the mineral component of enamel, dentin, or cement, reaching, if not arrested, a point of no return with the appearance of a severe cavitated lesion [5]. There is a progressive involvement of the dentine, and if not treated, there is an involvement of the dental pulp, and symptoms appear (tooth pain, infections, and abscesses, or even sepsis) [1]. When dental caries advances and arrives in dentine, the dentist has to remove the involved dentine: it is possible to do this through different methodologies, such as treatment with rotary instruments, manual excavator, air abrasion, sonic abrasion, ultrasonic methods, lasers, and chemo-mechanical
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