skip to main content

Full Pulpotomy Immature Tooth — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardPaediatric DentistryFull Pulpotomy Immature ToothORE Part 1

A 9-year-old child attends 48 hours after a complicated crown fracture of the maxillary right permanent central incisor. The tooth has an open apex and no associated luxation injury. The exposed pulp is vital. After rubber-dam isolation and removal of 2 mm of superficial coronal pulp, haemostasis is achieved within 5 minutes with sodium hypochlorite. Which pulp treatment is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Partial pulpotomy with a calcium-silicate cement

The correct treatment is **partial pulpotomy** (Cvek pulpotomy) using a calcium-silicate cement, such as MTA or Biodentine. In a traumatically exposed, vital pulp, removal of the superficial inflamed pulp until haemostasis is achieved preserves the healthy radicular pulp. This is particularly important in an immature tooth because it permits continued root maturation (apexogenesis). A complete coronal pulpotomy is more extensive than necessary when superficial pulp removal produces prompt haemostasis. Direct pulp capping leaves traumatised superficial pulp tissue in situ and has less favourable evidence than pulpotomy for complicated crown fractures. Pulpectomy sacrifices a vital pulp and is inappropriate where vital pulp therapy is feasible. Restoration alone leaves the pulp exposure untreated. Systematic-review evidence supports partial pulpotomy rather than pulp capping as the preferred treatment for complicated crown fractures in permanent teeth.

Reference: Duncan HF, et al. Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review. International Endodontic Journal. 2022. https://pubmed.ncbi.nlm.nih.gov/35076954/