Endodontics · single question

An 8-year-old patient presents with an uncomplicated crown fracture (Ellis Class 1) — only a small piece of enamel is chipped, with no dentin exposure and a positive vital pulp response. What is the most appropriate treatment?

  1. Pulpotomy with MTA due to proximity to pulp
  2. Direct pulp cap with calcium hydroxide
  3. Enameloplasty (smoothing and polishing) or composite resin restoration
  4. Root canal treatment due to risk of pulp necrosis in young patients
Show answer and explanation

Correct answer: C. Enameloplasty (smoothing and polishing) or composite resin restoration

Ellis Class 1 fracture involves ENAMEL ONLY — no dentin, no pulp exposure, vital pulp response. Appropriate treatment: If fracture is small with a smooth edge — enameloplasty (smoothing/rounding the sharp edge to prevent soft tissue irritation) is sufficient. If the fractured piece is available, it can be rebonded. If there is an esthetic concern or a larger enamel defect, composite resin restoration is indicated. Pulpotomy is reserved for Ellis Class 3 (pulp exposure in immature teeth). Direct pulp cap is for very small, FRESH pulp exposures. Root canal treatment is NOT indicated for an enamel-only fracture with a confirmed vital pulp. Memory aid: Ellis Class 1 = enamel only → smooth or restore; Class 2 = enamel + dentin → dentin coverage + restoration; Class 3 = pulp exposed → vital pulp therapy or RCT based on apex maturity.

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