This randomized clinical trial aims to evaluate the clinical and radiographic success of NeoPutty MTA compared to formocresol in vital pulpotomy of mandibular primary molars in children aged 4 to 9 years. Participants will be randomly allocated into two groups (1:1) to receive pulpotomy using either NeoPutty MTA or formocresol, followed by restoration with stainless steel crowns. Clinical and radiographic outcomes will be assessed during follow-up visits.

Pulpotomy is a commonly performed vital pulp therapy in pediatric dentistry. Formocresol has been widely used due to its high clinical success; however, concerns exist regarding its potential toxicity. NeoPutty MTA is a premixed bioceramic material introduced as an alternative pulpotomy agent with improved handling properties and bioactivity. This randomized parallel-group clinical trial will compare NeoPutty MTA versus formocresol in vital pulpotomy of mandibular primary molars. Children aged 4-9 years presenting with asymptomatic carious mandibular primary molars will be recruited from the Pediatric Dentistry Department, Faculty of Dentistry, MSA University. Eligible teeth will undergo standardized pulpotomy procedures, restoration with glass ionomer cement, and stainless steel crowns. Clinical and radiographic follow-up will be performed at scheduled intervals to evaluate success and failure outcomes.

Inclusion Criteria:

Children with asymptomatic decayed primary mandibular molar(s).

• Patient and parent showing cooperation and compliance.
• Children 4-9 years old.
• Vital carious primary(s) with complete root formation.
• Asymptomatic teeth or without clinical symptoms of spontaneous pain.
• No clinical evidence of pulp degeneration like the history of spontaneous or nocturnal pain, tenderness to percussion, pathologic tooth mobility, swelling, or fistulous tract.
• Both genders will be included.
• No radiographic evidence of pulp degeneration such as internal root resorption, external root resorption, or furcal radiolucency.
• Presence of two thirds of the root.
• Teeth that can be restored.
• Children with prior parental consent.

Exclusion Criteria:

• History of any systemic disease.
• Hemostasis is not achieved within 5 minutes of pulp amputation, by direct contact with a wet cotton pellet before the material placement.
• The remaining radicular tissue was non-vital (with suppuration or purulence necrosis).

the statistician will be blinded