Difference between revisions of "Dental fracture"

(Management)
(Management)
Line 16: Line 16:
 
*Enamel ('''Ellis Class I''')
 
*Enamel ('''Ellis Class I''')
 
**Routine follow up only; nothing to do
 
**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''')
 
*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

Revision as of 00:34, 19 July 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
    • 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
    • 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
    • Discharge with penicillin or clindamycin as they have pulpitis by definition

Disposition

  • Discharge with dental follow-up

See Also

Video

References