An experimental prospective double-blind, randomized clinical trial (RCT) with parallel design. To evaluate the outcome of using 2 pulpotomy agents: Totalfill® as study group and mineral trioxide aggregate (MTA®) as a control.

When a tooth decay is too deep and extended into the tooth pulp, then the tooth is not indicated to be treated with a filling. Therefore, removing the diseased pulp and then cover the rest with a suitable material is required. The Purpose of this study is to check the success of pulp treatment on deciduous molars with deep caries using 2 pulp treatment agents: (Totalfill® and MTA®). The use between the materials is randomly assigned. However, the use of the materials has no side effect or complications as it is a routine dental procedure.

The participants are healthy children aged between 3 and 9 years old, and the study is taking place in Ghent University Hospital, Ghent, Belgium, and it is planned to be conducted in duration of 4 years, which include 20 months for participants recruitment.

After placing the material, the tooth is restored with stainless steel crowns, and the participant was asked for follow up to check the tooth and to take dental x-ray every 6 months.

Inclusion Criteria:

1. Patient inclusion criteria

   • ASA 1 patient, Patient is a completely healthy & fit. No allergy or medical conditions.
   • Patient is indicated for treatment under General Anesthesia: young age, uncooperative and extensive treatment plan.
   • Parent agreed to participate in the study, and signed the written consent.
   • Patient attended the out-patients pediatric dental clinic in UZ Gent.

2. Tooth inclusion criteria 2.1. Clinical inclusion criteria:

   • Vital primary molars (first or second) with deep caries cavity with pulpal exposure.
   • Only mandibular primary molar were included
   • No spontaneous pain
   • No history of swelling
   • No sinus tract/ fistula
   • Absent of tenderness in percussion
   • No pathological mobility
   • Restorable tooth (stainless steel crown can be placed)
   • Hemostasis can be achieved with a dry cotton pellet after removal of Coronal pulp.

2.2. Radiographical inclusion criteria:

• At least 2/3rd of root is present
• Absence of internal or external root resorption
• Absence of pathologic root resorption
• Absence of periapical or furcation radiolucency

Exclusion Criteria:

If one or more of the criteria mentioned above is not fulfilled, the teeth were excluded from the study.

The data will be available in the literature in the manuscript after publication

After publication

The included teeth were assigned randomly into two groups (Totalfill or MTA) using randomized sequences generated by the computer using Random Integer Generator (RANDOM.ORG, Randomness and Integrity Services Ltd.). The allocation ratio to the groups was set to be equal.

To ensure double blinding at both patients and evaluators level during treatment, the type of material was concealed from the patient, and the patient had no information which material was used. In addition, the type of material was not mentioned in the patient file. Instead, it was replaced by a 4 digit code. The operators were also blinded for the type of material during the whole procedure starting from tooth preparation till the hemostasis was achieved and then were only informed at the time of material placement.