Difference between revisions of "Dental fracture"

Line 3: Line 3:
  
 
==Clinical Features==
 
==Clinical Features==
 
+
*Localized tooth fracture
 +
*History of oral trauma
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
Line 9: Line 10:
  
 
==Evaluation==
 
==Evaluation==
 
+
*Clinical diagnosis
 +
*Consider obtaining panorex to evaluate for associated bone fracture
  
 
==Management==
 
==Management==
#Enamel ('''Ellis Class I''')
+
*Enamel ('''Ellis Class I''')
##Routine follow up only; nothing to do
+
**Routine follow up only; nothing to do
#Enamel + dentin (yellowish) ('''Ellis Class II''')
+
*Enamel + dentin (yellowish) ('''Ellis Class II''')
##Patients experience sensitivity to hot/cold stimuli and air passing over tooth during breathing
+
**Patients experience sensitivity to hot/cold stimuli and air passing over tooth during breathing
##Cover exposed dentin to decrease pulpal contamination
+
**Cover exposed dentin with calcium hydroxide to decrease pulpal contamination
###Place dental cement over fracture site
+
**Next day follow up
###Next day follow up
+
*Enamel + dentin + pulp (reddish) ('''Ellis Class III''')
#Enamel + dentin + pulp (reddish) ('''Ellis Class III''')
+
**On wiping fractured surface with gauze, blood is easily seen
##On wiping fractured surface with gauze, blood is easily seen
+
**Immediate dental referral (dental emergency) - should be seen within 24 hours
##Immediate referral (dental emergency)
+
**If not able to be seen immediately, cover exposed pulp with calcium hydroxide
##If no dentist is available:
 
###Cover exposed pulp with calcium hydroxide base
 
###Cover this and the remaining exposed dentin with dental cement
 
  
 
==Disposition==
 
==Disposition==
 
+
*Discharge with dental follow-up
  
 
==See Also==
 
==See Also==
*[[Dental Problems]]
+
*[[Dental problems]]
  
 
==Video==
 
==Video==

Revision as of 00:41, 12 February 2017

Background

Clinical Features

  • Localized tooth fracture
  • History of oral trauma

Differential Diagnosis

Dentoalveolar Injuries

Odontogenic Infections

Other

Evaluation

  • Clinical diagnosis
  • Consider obtaining panorex to evaluate for associated bone fracture

Management

  • Enamel (Ellis Class I)
    • Routine follow up only; nothing to do
  • 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
    • 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

Disposition

  • Discharge with dental follow-up

See Also

Video

References