Children with deep carious lesions and no history of spontaneous pain will undergo standardized periapical and bitewing radiographs. Eligible teeth will be randomly assigned to three groups based on the material used.

During IPT, after topical anesthesia, the tooth will be isolated with a rubber dam. Caries will be removed using a slow-speed handpiece with a round carbide bur. Lateral walls and cavosurface margins will be fully cleaned, while affected dentin at the pulpal floor will be preserved. The cavity will be flushed with saline for 10 seconds and dried with cotton pellets.

For Group I, TheraCal PT will be applied with a syringe, light-cured for 10 seconds, followed by an RMGIC base and composite restoration. In Group II, premixed MTA will be applied with a syringe for 30 seconds, condensed lightly, followed by an RMGIC restoration. In Group III, calcium hydroxide will be mixed in equal parts, applied with ball-ended condensers, followed by an RMGIC restoration.

All cavities will receive RMGIC restoration. A baseline radiograph with a grid will be taken using an XCP holder. Clinical and radiographic evaluations will be performed at 3, 6, and 12 months, assessing pain, percussion tenderness, discoloration, and sinus formation. Radiographs will be scanned and analyzed digitally.

Dentin thickness will be measured using CorelDRAW software. Radiographs will be assessed for root resorption, PDL space widening, periapical radiolucency, dentin formation, and intrapulpal calcifications. Treatment success will require pulp vitality with no spontaneous pain. Radiographic success will require reactionary dentin formation without furcation radiolucency, PDL widening, or root resorption.