In enamel-dentin-pulp fracture with pulp exposure, which procedure may preserve vitality in an immature tooth?

Prepare for the American Board of Pediatric Dentistry Oral Boards. Utilize flashcards and multiple-choice questions with hints and explanations to ace your exam!

In an immature tooth with enamel-dentin-pulp fracture and pulp exposure, keeping the pulp alive is crucial to allow continued root development and natural apex formation. A Cvek pulpotomy, which is a partial pulpotomy, targets the inflamed coronal pulp and preserves the healthy radicular pulp. By removing only the affected tissue and then placing calcium hydroxide over the exposed area, you encourage a favorable reparative response and dentin bridge formation, supporting long-term vitality and continued root maturation. This approach aligns with the goal in young patients to maintain tooth vitality so the root can continue to develop, reducing the need for gradual endodontic closure of the root.

Extraction would discard the tooth and for an immature dentition can create space and occlusal problems. Performing endodontic therapy for all cases would remove vitality and halt ongoing root development, leading to a structurally weaker tooth with a closed apex. Watchful waiting without intervention risks ongoing inflammation, necrosis, and failure of the tooth to recover, which is especially problematic when a pulp is exposed.