Which treatment is most appropriate for a primary tooth with irreversible pulpitis?

A primary tooth with irreversible pulpitis involves significant inflammation of the dental pulp, indicating that the pulp is no longer healthy and cannot be saved through conservative means. In such cases, the most suitable treatment is pulpectomy.

Pulpectomy involves the complete removal of the infected pulp tissue from the tooth, followed by the cleaning and shaping of the canal system. After this, the void left by the pulp is filled with a biocompatible material. This procedure is essential for managing irreversible pulpitis since it not only alleviates pain and infection but also maintains the primary tooth structure for as long as possible, allowing for normal function and development of the jaw until the permanent tooth erupts.

While pulpotomy is a treatment option for teeth with pulpitis that is still reversible, it would not be appropriate for irreversible cases where the pulp is necrotic. Extraction may be considered in some cases, but it is typically a last resort, especially in primary teeth where maintaining the tooth is often preferable for dental and developmental reasons. Indirect pulp treatment is more suitable for situations where there is a chance to save the pulp, which does not apply here, as irreversible pulpitis indicates that saving the pulp is no longer feasible.