Difference between revisions of "Dental fracture"

(Management)
(Management)
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**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 with calcium hydroxide to decrease pulpal contamination
 
**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
 
**Next day follow up
 
*Enamel + dentin + pulp (reddish) ('''Ellis Class III''')
 
*Enamel + dentin + pulp (reddish) ('''Ellis Class III''')

Revision as of 13:45, 28 November 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
      • 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
    • Discharge with penicillin or clindamycin as they have pulpitis by definition

Disposition

  • Discharge with dental follow-up

See Also

Video

References