Papain associated with root planing in treatment of periodontitis

Although subgingival scaling and root planing (SRP) are the "gold standard" treatment for periodontitis, these processes may remove excessive cement, exposing dentin and causing hypersensitivity, or producing defects such as ridges and grooves, leaving residual calculus and preventing access to the whole of the root surface. A papain gel that removes carious dentin (Papacárie®) has been introduced and this gel may also help to remove supra and subgingival calculus, acting on its organic portion and biofilm, decreasing the consumption of cement and generating lower levels of aerosol compared to SRP. The aim of the present split-mouth, single-blind study was thus to compare the effectiveness of papain gel with subgingival root planning (RP). After receiving oral hygiene instruction, supragingival scaling, and coronary polishing, 18 periodontitis patients (6 women and 12 men, mean age of 51 ± 8 years) were included in the study. Treatment involved subgingival application of the gel for one minute, followed by RP while the control group received subgingival SRP. Treatment was conducted by three operators and a blinded examiner recorded the following clinical parameters at baseline and after three months: plaque index (PI), bleeding on probing (BoP), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR). The results showed significant improvements in clinical parameters, in both the treatment and the control group, with no statistical difference between them. It was concluded that papain did not provide any additional.