COMPARATIVE EVALUATION OF THE EFFICACY, TIME TAKEN AND PAIN PERCEPTION OF PAPACARIE, V-CARIE-SOLVE AND CONVENTIONAL HAND INSTRUMENTATION FOR CARIES REMOVAL IN PRIMARY MOLARS: A RANDOMIZED CONTROLLED TRIAL

This randomized controlled trial aims to compare the clinical efficacy, microbial efficacy, time taken, and pain perception associated with three different caries-removal techniques—Papacarie, V-Carie-Solve, and conventional hand instrumentation—in primary molars of children aged 4–9 years. Sixty-six carious primary molars meeting strict inclusion criteria (ICDAS 5 or 6 lesions, radiographic dentinal involvement without pulpal extension, Frankl 3 or 4 behaviour) will be randomly assigned into three equal groups of 22 teeth each.

In Group I, caries removal will be performed using the papain-based chemomechanical gel Papacarie, applied for 30–40 seconds followed by gentle excavation. Group II will undergo a similar protocol using V-Carie-Solve, a newer papain- and clove-oil–based gel. Group III, the control group, will receive caries removal solely through conventional hand instrumentation using a spoon excavator.

Before and after excavation, dentinal samples will be collected and transported in Brain Heart Infusion Broth for microbiological analysis, with colony-forming units quantified using blood agar plating under anaerobic incubation. Clinical efficacy will be assessed through visual and tactile criteria using the Ericson 0–5 scoring system. Time taken for complete excavation will be recorded using a stopwatch, while pain perception will be evaluated using both subjective (Wong-Baker FACES) and objective (FLACC) scales during and after the procedure. Final restorations will be placed using glass ionomer cement.

The study seeks to determine whether chemomechanical agents offer superior comfort, reduced microbial load, and acceptable clinical performance compared to conventional hand excavation, ultimately contributing to minimally invasive and child-friendly dentistry.