An 8,5-year-old child is apparently healthy. The child complains about pain in an upper tooth on the left caused by traumatic injury sustained three hours ago. Objectively: the crown part of the 21 tooth is destroyed by 1/2, the pulp is red and significantly exposed, probing causes acute pain and bleeding. Percussion of the 21 tooth is extremely painful. Choose the most efficient treatment method of the 21 tooth:

Answer options

1. Devital extirpation
2. Vital amputation
3. Bioassay technique
4. Devital amputation
5. Vital extirpation

Explanation

First of all pay attention to clinical manifestations of tasks and indications for each treatment approach. The choice of the method of treatment depends on the time, passed since the moment of trauma, (physically damaged 3 hours ago), root development stage, (8,5-year-old child tooth 21 – stage of root formation) the size of exposed pulp, (the pulp is significantly exposed)somatic health of the child (child is mostly healthy). Pulp viability preservation is extremely important for immature teeth. (Devital methods are not good) In case of dotted pulp exposure in a tooth with immature roots, a biological method of treatment or a vital amputation is used (if it has passed not more than 6 hours after the trauma). If the pulp exposition area is significant or dotted, but the after trauma time period is 1–3 days, it is necessary to perform a vital amputation In teeth with the mature root a vital or devital pulp extirpation is performed;