Cryotherapy Efficacy During Pulp Therapy of the Mandibular First Permanent Molars in Children

Inclusion Criteria: * Healthy children aged 9-17 years who were categorized as class I or II according to the ASA classification. * Cooperative children (rate 3 or 4 according to Frankl behavior rating scale) * Presence of a vital mandibular first permanent molar with SIP, the tooth should show deep caries or dental restorations with a history of spontaneous lingered pain precipitated by thermal stimuli. To confirm the diagnosis of irreversible pulpitis, early response to electric pulp and thermal testing was performed. * No radiographic changes with at least two-thirds of the root must be evident. Exclusion Criteria: * Children with severe emotional, intellectual, and behavioral difficulties. * Necrotic pulp of primary molars. * Unrestorable crowns * Positive history of gingival swelling, abnormal mobility, and fistulous tract. * Presence of radiographic signs of periapical and/or furcation radiolucency, and pathological resorption.