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Dental Trauma, continued
7. Fracture
There are 5 basic types of tooth fracture:

1. Uncomplicated Fracture of Enamel
 
Fracture (crack) of the enamel without involving the dentin or the pulp. May have a sharp edge.
 
Inspect injured lips, tongue, and gingiva to rule out presence of tooth fragments
 
Refer to a dentist for evaluation as soon as possible (within 12 to 24 hours), where a radiograph to exclude underlying root fracture may be required.
 
Recommend long-term follow-up to evaluate for complications, which are uncommon.

2.
Dentin: A calcareous material similar to bone but harder and denser that composes the principal mass of a tooth; consists of a matrix containing minute parallel tubules which open into the pulp cavity and during life contain processes of the cells of the pulp.
Uncomplicated fracture of Dentin and
Enamel: Intensely hard calcareous substance that forms a thin layer partly covering the teeth; the hardest substance of the animal body; consists of minute prisms arranged at right angles to the surface and bound together by a cement substance.
Enamel.
 
An enamel-dentin fracture that does not involve the pulp and can be recognized by the yellow to pink color of the dentin. Can cause sensitivity to temperature and pain (due to innervation).
 
Potential complications include pulp death, infection.
 
Inspect injured lips, tongue, and gingiva to rule out presence of tooth fragments
 
Provide a soft diet, avoiding temperature extremes.
 
If a primary tooth is injured, refer to a dentist for further treatment.
 
If a permanent tooth is injured, refer to a dentist within 12 to 24 hours to cover exposed dentin of permanent incisors. If fractured piece of tooth has been saved, it may be used to restore the tooth.

3. Dentin, Enamel, and
Pulp: The highly vascular sensitive tissue occupying the central cavity of a tooth.
Pulp Death (Complicated Crown Fracture)
 
An enamel-dentin fracture with pulp exposure.
 
The fracture site has a reddish tinge or will show some bleeding.
 
Can cause extreme pain and may lead to pulpal necrosis. Also presents a risk of root resorption and infection in exposed pulp.
 
Refer to dentist as soon as possible (within 12 to 24 hours) for evaluation.
 
Requires pulpotomy or pulpectomy (root canal), sometimes extraction.
 
Pain can be severe, so analgesia is important.

4. Dentin, Pulp, and
Cementum: A specialized external bony layer covering the dentin of the part of a tooth normally within the gum.
Cementum Fracture
 
A fracture with pulp exposure.
 
Potential complications include root resorption and pulp necrosis.
 
Refer to dentist as soon as possible (within 12 to 24 hours) for evaluation, where diagnosis will be made through radiograph.
 
Treatment consists of reduction and splinting or extraction.

5. Root Fracture
 
Includes pulp exposure.May be indicated by excess mobility of the tooth.
 
Potential complications include resorption and pulp necrosis.
 
Refer to dentist as soon as possible (within 12-24 hours) for evaluation, where diagnosis is made radiographically.
 
Treatment consists of reduction and splinting for permanent teeth or extraction, depending on the extent of the traumatic lesion.
 
 
The 4 types of tooth fracture can only be distinguished by radiographs.
 
Complications of tooth fractures include pulp death, root resorption, and infection.
     
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