A Comparative Evaluation of the Efficiency of Bromelain as a Chemomechanical Caries Removal Agent with Carie-Solve and Brix 3000: An in Vitro Study

Background: Conventional rotary instrumentation removes carious dentin non-selectively, prompting growing interest in chemomechanical caries removal (CMCR) agents that chemically soften degraded collagen while conserving sound tooth structure. Aim: The present study aimed to evaluate and compare the efficacy, residual dentin microhardness, and residual demineralised dentin thickness of Carie-Solve, Brix 3000, and a self-formulated bromelain gel in extracted primary mandibular molars. Materials and Methods: An in vitro comparative study was conducted on 54 extracted carious primary mandibular molars, allocated equally into three groups treated with Carie-Solve, Brix 3000, or a self-prepared bromelain gel. Time taken and number of applications for complete caries removal, Knoop microhardness of residual dentin at 50, 250 and 500 µm, and residual dentin thickness were recorded and statistically compared using one-way ANOVA with Tukey's post hoc test. Results: The bromelain group required significantly less time (227.39 ± 22.12 seconds) for complete caries removal than Carie-Solve (292.72 ± 25.87 seconds) and Brix 3000 (241.33 ± 17.18 seconds) (p<0.001), and exhibited significantly higher microhardness and residual dentin thickness values than both comparator agents (p<0.001). Conclusion: All three agents achieved complete caries excavation; however, bromelain demonstrated superior clinical efficiency and greater tissue conservation, supporting its potential as an indigenous, cost-effective chemomechanical caries removal agent in paediatric dentistry.