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Endodontics · single question

For direct pulp capping (DPC) of an Ellis Class 3 anterior fracture in an 8-year-old (immature apex), the preferred treatment is:

  1. Apexification with Ca(OH)2
  2. Apexogenesis (vital pulp therapy with Ca(OH)2 or MTA)
  3. Extraction and space maintainer
  4. Immediate root canal treatment (RCT)
Show answer and explanation

Correct answer: B. Apexogenesis (vital pulp therapy with Ca(OH)2 or MTA)

  • A. Apexification (Ca(OH)2 or MTA apical barrier) is used when the pulp is NECROTIC in an immature tooth. Since this is a recent fracture with vital pulp exposure, apexogenesis is preferred first.
  • B. Correct. In an 8-year-old with an immature apex (incomplete root development), preserving pulp vitality allows continued root development. Apexogenesis (vital pulp therapy — partial pulpotomy with MTA or Ca(OH)2) is the treatment of choice to allow physiological root completion.
  • C. Extraction is not indicated for a restorable anterior tooth in a young patient.
  • D. RCT in an immature tooth produces a thin-walled, short root prone to fracture. It is a last resort when pulp is non-vital.

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