**Question:** 5 hours ago a 7-year-old boy had a fall. He fractured
his maxillary right central incisor at gingival level. The
exposed pulp is still vital. Treatment of choice is:

A. Pulpectomy
B. Pulpotomy
C. Crown placement
D. None of the above

**Answer Explanation:**

**Core Concept:**
In children, a fractured tooth with an exposed pulp indicates a pulpally-involved tooth. Pulpally-involved teeth require pulp treatment to preserve the tooth's vitality. Pulpally-involved teeth can either have a necrotic or vital pulp. In this case, the pulp is vital, meaning it still has blood supply and the tooth can be saved.

**Why the Correct Answer is Right:**
The correct answer is B. Pulpotomy. This is because a pulpotomy is the appropriate treatment for a pulpally-involved tooth with a vital pulp. Pulpotomy involves removing the infected or inflamed coronal portion of the pulp, preserving the healthy radicular pulp, and providing a suitable restorative material to cover the exposed pulp to protect it and prevent further inflammation.

**Why Each Wrong Option is Incorrect:**
A. Pulpectomy (Option A) is incorrect because it involves complete removal of the pulp, making it unsuitable for a tooth with a vital pulp.

C. Crown placement (Option C) is incorrect as it does not address the inflammation or infection of the pulp, only provides a protective covering around the tooth.

D. None of the above (Option D) is incorrect because Pulpotomy (Option B) is a suitable treatment for a tooth with a vital pulp, as mentioned above.

**Clinical Pearl:**
In children, pulpotomy is a valuable treatment option for a fractured tooth with a vital pulp, ensuring preservation of the tooth and preventing further damage. Timely intervention is crucial in these cases, as untreated pulp involvement can lead to chronic pulpitis, apical periodontitis, and potential tooth loss.