الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Dental caries is a severe global issue that is regarded as the most chronic disease with a wide spread, impacting a large number of children in various countries. It has been related to multifactorial etiology, where diet and oral flora play an essential role. The critical factors for tooth demineralization are acid production by microbial metabolism of sugars and the prolonged periods of low oral pH. The ideal cutting instrument in caries removal should achieve certain requirements to satisfy both operator and patient. These factors might include comfort, ease of use in clinical environment, the ability to remove diseased tissue only. Also, they should be painless, silent requiring only minimal pressure for optimal use, not generating vibration or heat during periods of operation and being affordable & easy to maintain. Minimally invasive dentistry (MID) is the modern approach to the management of caries. This includes chemo-mechanical techniques, air abrasion with aluminium oxide or glass particles, sono-abrasion, ultrasonic instrumentations, laser and polymer bur. The Chemo-mechanical agents have the ability to identify the superficial and highly infected dentin from the internally affected dentin, which can give a chance for the remineralization of the affected dentin. There are lots of chemo-mechanical techniques have been developed, Some of them were abandoned due to lack of efficacy and its complex delivery equipment as caridex .In 2016 in Argentina, new material had been declared and named ’Brix 3000’, which has many beneficial properties due to increase the amount of papain used and the bio encapsulation of papain by encapsulated buffer emulsion (EBE) technology achieving higher proteolysis effectiveness to remove the collagen fibrils in the decayed dentin, less dissolution by the oral fluids, greater resistance to storage even in unfavorable conditions . It has greater antibacterial and antifungal potency. It also has nontoxic effect on oral tissues, as it does not provoke abnormal reactions when it comes into contact with the healthy tissue. This study was carried out to evaluate the clinical efficacy of Papain compared to the conventional bur preparation in caries removal in primary teeth. Thirty healthy cooperative children aged from (4-7) years with bilateral Class I open cavity and free from any medical condition were included. An informed consent was taken from parents. The sixty teeth were divided into two groups; group I dental caries was removed by using Brix 3000 while group II dental caries was removed by conventional caries removal. Clinical assessment was done for the assessment of pain reaction using Sound, Eye and Motor scale (SEM) and the total working time required for caries removal using either method was recorded in minutes using a stopwatch, while microbiological assessment was done to calculate Streptococcus mutans and Lactobacilli counts. In this study, mean age was 6.31 years. regarding operation time for group I, the mean time required for complete caries removal was 30.23 min with the minimum time 25 min and the maximum time 35 min while for group II the mean time required for complete caries removal was 20 min with the minimum time 16 min and the maximum time 25 min.