A child with a fractured central incisor presents three hours after injury with pulp exposure. What is the preferred treatment?

The preferred treatment for a child with a fractured central incisor and pulp exposure is to remove the surface 1-2 mm of pulp tissue and place calcium hydroxide. This method, often referred to as partial pulpotomy or vital pulp therapy, is designed to maintain the vitality of the remaining pulp tissue while providing a protective barrier over the exposed area.

Calcium hydroxide is utilized in this scenario because of its properties that promote healing and create a favorable environment for pulp regeneration. It helps to seal the exposed area, reducing the risk of bacterial infection and inflammation while also facilitating the formation of a reparative dentin layer.

This treatment approach is particularly crucial in children since their teeth are still developing. Preserving the vitality of the tooth allows for continued root development and growth, which would not be achievable through more aggressive treatments like pulpectomy or formocresol pulpotomy. These alternatives are used more commonly in adult teeth or when the pulp is significantly unhealthy.