Dental fracture
Background
Diagnosis
Management
- Enamel (Ellis Class I)
- Enamel + dentin (yellowish) (Ellis Class II)
- Enamel + dentin + pulp (reddish) (Ellis Class III)
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Management
- Enamel (Ellis Class I)
- Routine f/u only; nothing to do
- Enamel + dentin (yellowish) (Ellis Class II)
- Pts experience sensitivity to hot/cold stimuli and air passing over tooth during breathing
- Cover exposed dentin to decrease pulpal contamination
- Place dental cement over fracture site
- Next day f/u
- Enamel + dentin + pulp (reddish) (Ellis Class III)
- On wiping fractured surface with gauze, blood is easily seen
- Immediate referral (dental emergency)
- If no dentist is available:
- Cover exposed pulp with calcium hydroxide base
- Cover this and the remaining exposed dentin with dental cement
See Also
Video
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References
- ER Atlas
- Tintinalli
- UpToDate