Effect of papain gel pretreatment on the remineralizing potential of casein phosphopeptide-amorphous calcium phosphate fluoride varnish in white spot lesions: A randomized controlled trial.

AIM: This study aimed to compare the remineralizing potential of casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) varnish alone and CPP-ACPF varnish after applying papain gel, quantitatively using LASER fluorescence readings and qualitatively using scanning electron microscopy (SEM).

MATERIALS AND

METHODS

A total of 108 permanent teeth with white spot lesions were divided into Group I: papain gel applied before CPP-ACPF varnish and Group II: CPP-ACPF varnish alone. Remineralization was monitored with DIAGNOdent laser fluorescence readings at baseline, 1, 3, 6, and 9 months. In addition, we randomly selected three samples from each Group after treatment for SEM evaluation.

RESULTS

Statistical analysis revealed no significant difference in remineralization efficacy between the two groups. However, the percentage reduction in DIAGNOdent readings from baseline to 9 months was significantly higher in Group I than in Group II. SEM analysis supported these findings by showing better surface integrity in Group I samples.

CONCLUSION

Although overall remineralization efficacy did not differ significantly between groups, the combination treatment (papain gel + CPP-ACPF varnish) demonstrated increased longevity of preventive outcomes compared to CPP-ACPF varnish alone. The trial was prospectively registered at CTRI under registration number 2020/01/022962.