In a patient with hyperplastic pulpitis, which tooth is most likely the cause?

Hyperplastic pulpitis, often referred to as "pulp polyp," is a condition where the dental pulp becomes inflamed and hypertrophied, usually following a carious lesion. This condition is more commonly seen in primary molars, particularly in children.

Primary molars are typically the last primary teeth to erupt and, due to their function in chewing and the occlusal forces they endure, are more susceptible to caries, which can lead to the development of hyperplastic pulpitis. Once the caries reach the pulp, the pulp tissue can become necrotic and subsequently proliferate, leading to the characteristic appearance of hyperplastic pulpitis.

While other teeth can also be affected by pulpitis, the prevalence of hyperplastic pulpitis in primary molars makes this the most likely tooth associated with the condition in a patient, especially in pediatric cases. The anatomy of primary molars, with their larger pulp horns and less dense dentin, contributes to their increased vulnerability to carious involvement, thus resulting in hyperplastic changes within the pulp.