Difference between revisions of "Dental fracture"
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**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 dental referral (dental emergency) - should be seen within 24 hours | ||
| − | **If not able to be seen immediately, cover exposed pulp with calcium hydroxide | + | **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 | **Discharge with penicillin or clindamycin as they have pulpitis by definition | ||
Revision as of 13:47, 28 November 2017
Contents
Background
Clinical Features
- Localized tooth fracture
- History of oral trauma
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental caries (pulpitis)
- Ludwig's angina
- Periapical abscess
- Pericoronitis
- Periodontal abscess
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
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 and dental cement.
- Discharge with penicillin or clindamycin as they have pulpitis by definition
Disposition
- Discharge with dental follow-up
See Also
Video