Stain removal effect of novel papain- and bromelain-containing gels applied to enamel.

OBJECTIVES: The aims of the study are to prepare novel stain removal gel-based formulations containing papain or bromelain and to investigate their stain removal effect when applied to enamel. MATERIALS AND METHODS: Experimental bromelain- and papain-based stain removal gels were prepared. Next, enamel/dentin tooth samples (6 x 6 mm(2), 4 mm in thickness) were obtained from bovine teeth, stained in coffee solution for 1 week, and measured with a digital spectrophotometer (Easyshade, Vita Zahnfabrik) for color assessment (baseline). The samples were then randomly allocated into four groups (n = 7), according to the stain removal agent applied: ContrastPM+ (Discus Dental, LLC), which is based on 20 wt.% carbamide peroxide (positive control); bromelain-based; papain-based; and no agent (negative control). The materials were applied once a week, three times per day, during 4 weeks, and following the directions of use from positive control. The samples were measured again with the Easyshade and using the CIEL (*) a (*) b (*) color system. The color change (DeltaE (*)) results were obtained by subtracting the baseline values from the final color values obtained at each time point. The data were statistically analyzed using two-way repeated-measures analysis of variance and Student Newman Keuls's test as a post hoc test (alpha = 5 %). RESULTS: All stain removal agents produced greater color change than the negative control (p < .001), with the positive control demonstrating greater DeltaE (*) values when compared to the experimental gels (p </= .004). The second application of all gels resulted in greater DeltaE (*) values compared to the first application (p </= .025), although no color change was observed after the third application (p >/= .051), regardless of the material evaluated. CLINICAL SIGNIFICANCE: The proposed gels containing proteolytic enzymes (bromelain or papain) of vegetal origin may hold significant clinical potential as active agents for the preparation of stain removal agents free of hydrogen/carbamide peroxide.