Tooth fracture

Last Updated on by frcemuser




  • Enamel (Ellis Class I)
    • Routine follow up only; nothing to do
    • May consider filing down sharp edges with an emery board for comfort
  • Enamel + dentin (yellowish) (Ellis Class II)
    • Patients experience sensitivity to hot/cold stimuli and air passing over tooth during breathing
    • Cover exposed dentin with calcium hydroxide to decrease pulpal contamination
      • Greater than 2 mm of dentin offers more protection to pulp, can be covered with dental cement only. If dentin is less than 0.5 mm then cover with calcium hydroxide and dental cement over it.
    • Next day follow up
  • Enamel + dentin + pulp (reddish) (Ellis Class III)
    • On wiping fractured surface with gauze, blood is easily seen
    • Immediate dental referral (dental emergency) – should be seen within 24 hours
    • If not able to be seen immediately, cover exposed pulp with calcium hydroxide and dental cement.
    • Discharge with penicillin or clindamycin as they have pulpitis by definition
  • Crown Root/Root fracture- not a common dental injury
    • Treatment for both is reduction, stabilization if fracture segment is stable and outpatient follow with dentist in 24-48 hours.
      • If fracture segment unstable/very mobile may need to extract to prevent aspiration.
    • Crown Root fracture does not always involve pulp vs root fractures almost always involves pulp.

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