A 12-year-old patient presents 24 hours after a complicated crown fracture (pulp exposed) of a permanent maxillary central incisor. Which treatment is most appropriate?

For a permanent incisor with a pulp exposure after traumatic injury, the treatment choice depends on the time elapsed since injury and the vitality/health of the pulp. At 24 hours with a likely vital pulp in a 12-year-old (immature apex, open apex), a partial pulpotomy (Cvek pulpotomy) is the preferred treatment. This approach removes the superficially contaminated 2-3 mm of pulp tissue, places MTA or calcium hydroxide, and seals the tooth — allowing continued root development (apexogenesis). Complete root canal treatment is indicated if the pulp is necrotic or if the tooth has a closed apex. Direct pulp capping (without removal of contaminated tissue) has a lower success rate after 24 hours.