Difference between revisions of "Dental fracture"
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*Discharge with [[penicillin]] or [[clindamycin]] as they have [[pulpitis]] by definition | *Discharge with [[penicillin]] or [[clindamycin]] as they have [[pulpitis]] by definition | ||
| − | ===Crown Root/Root fracture | + | ===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. | *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. | **If fracture segment unstable/very mobile may need to extract to prevent aspiration. | ||
Latest revision as of 06:00, 10 December 2019
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
- 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.
Disposition
- Discharge with dental follow-up
See Also
External Links
Video