A 4-year-old primary molar has deep caries with pulp involvement. What is the treatment of choice?

Correct answer: B. Pulpotomy followed by stainless steel crown (SSC)

• A. Incorrect. Direct pulp cap in primary teeth has poor long-term success and is generally not recommended when caries have reached the pulp.
• B. Correct. For a primary molar with PULP INVOLVEMENT, the treatment of choice is PULPOTOMY (removal of the coronal pulp, preservation of the radicular pulp with formocresol or MTA) followed by a STAINLESS STEEL CROWN (SSC) for full coverage and protection. This is the evidence-based standard of care for multi-surface carious primary molars.
• C. Incorrect. Extraction is the last resort and would require a space maintainer — premature loss of primary molars leads to space loss and orthodontic problems.
• D. Incorrect. Indirect pulp cap is for lesions where a thin dentin barrier remains and the pulp is NOT yet exposed — not appropriate for clinical pulp involvement.