INBDE (Integrated National Board Dental Examination) Practice Exam

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Which of the following is the treatment of choice for a 7-year-old child with a nonvital tooth #30 with a buccal sinus tract?

  1. Extraction

  2. Pulpotomy

  3. Apexification

  4. Direct pulp capping

The correct answer is: Apexification

In a 7-year-old child with a nonvital tooth #30 and a buccal sinus tract, the treatment of choice is apexification (Option C). Apexification involves inducing a calcified barrier in the open apex of a nonvital tooth to create a seal and allow for root canal filling. Since the tooth is nonvital and has a sinus tract, it is important to address the infected pulp and root canal system to prevent further complications. Extraction (Option A) would not be the first choice in a 7-year-old child if the tooth can be saved and maintained to preserve the arch length and function. Pulpotomy (Option B) involves the removal of the coronal portion of the pulp in vital teeth, which is not suitable for a nonvital tooth with a sinus tract. Direct pulp capping (Option D) is also not appropriate in this case as it is typically indicated for vital teeth with small exposures, rather than nonvital teeth with sinus tracts that require more extensive endodontic treatment like apexification.