Pediatric Dentistry · single question
PEDIATRIC CASE (continued): What is the best treatment for this necrotic primary molar (tooth F) with a sinus tract and NO visible roots on radiograph?
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Correct answer: B. Extraction
When a primary tooth shows complete or near-complete root resorption (no roots visible on X-ray) combined with a sinus tract and pulp necrosis, extraction is the treatment of choice. There are no roots to do a pulpectomy on. Monitoring would allow persistent infection. Pulpotomy is only for vital pulps. The tooth is effectively exfoliating, but the periapical infection requires active intervention — extraction is indicated.
- A. CORRECT. No roots visible on X-ray + sinus tract = extraction is indicated. Root canal therapy is not possible without roots, and the infection must be eliminated.
- B. Incorrect. Simply monitoring an infected, draining primary tooth with no roots is inappropriate — the chronic infection can damage the underlying permanent tooth bud.
- C. Incorrect. Pulpectomy requires canal anatomy — with no roots present, this is not feasible.
- D. Incorrect. Pulpotomy with formocresol addresses vital coronal pulp tissue — this tooth has irreversible pulp necrosis with periapical abscess, not a vital pulp.
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