Exploring papain for root canal disinfection: Antibiofilm efficacy and biocompatibility in vitro

Introduction: Safer, biocompatible alternatives to NaOCl for endodontic irrigation are being explored; papain (a plant protease) could be one. Methods: E. faecalis biofilms on dentin discs treated with 4% papain, 2.5% NaOCl, or saline. Outcomes: CFU counts, CLSM for viability and EPS; cytotoxicity via MTT on fibroblasts. Statistical testing via ANOVA/non-parametric tests (p<0.05). Results: Papain had antibiofilm activity but lower bactericidal effect than NaOCl. Papain reduced EPS content most effectively and showed significantly lower cytotoxicity than NaOCl. Conclusions: Papain disrupts biofilm matrix with better biocompatibility than NaOCl — a promising adjunct/alternative irrigant warranting further investigation.