Enamel-dentin fracture - diagnostic signs

Description A fracture confined to enamel and dentin with loss of tooth structure, but not involving the pulp.
Visual signs Visible loss of enamel and dentin. No visible sign of exposed pulp tissue.
Percussion test Not tender. If tenderness is observed evaluate the tooth for possible luxation or root fracture injury.
Mobility test Normal mobility.
Sensibility pulp test Usually positive. The test may be negative initially indicating transient pulpal damage. Monitor pulpal response until a definitive pulpal diagnosis can be made.

The test is important in assessing future risk of healing complications. A lack of response at the initial examination indicates an increased risk of later pulp necrosis.
Radiographic findings The enamel-dentin loss is visible.
Radiographs recommended Periapical, occlusal and eccentric exposure. They are recommended in order to rule out displacement or the possible presence of a root fracture.

Radiograph of lip or cheek lacerations to search for tooth fragments or foreign material.

Dental Trauma Guide 2010 - produced in cooperation with the Resource Centre for Rare Oral Diseases and Department of Oral and Maxillo-Facial Surgery
at the University Hospital of Copenhagen - Last edited the 07-01-2014.