A young permanent incisor with an open apex has a pinpoint exposure due to a traumatic injury that occurred 24 hours previously. The best treatment is
Because the exposure site is likely significantly contaminated from the injury that occurred 24 hours previously, direct pulp capping with calcium hydroxide is contraindicated. A calcium hydroxide pulpectomy should not be the automatic procedure accomplished because continued root elongation and closure of the pulp canal will likely not occur. A calcium hydroxide pulpotomy is preferable for a traumatized tooth with an open apex with either a large exposure or a small exposure of several hours or days postinjury. Clinically, the tooth should be anesthetized and, under sterile conditions, and the clinician should open the pulp chamber in search of healthy pulp tissue. It is likely that vital tissue will be present within 24 hours of the injury.
Place calcium hydroxide on the pinpoint exposure
Open the pulp chamber to find healthy pulp tissue and perform a pulpotomy
Initiate a calcium hydroxide pulpectomy
Initiate conventional root canal treatment with gutta-percha