Enamel fracture - diagnostic signs

Description A fracture confined to the enamel with loss of tooth structure.
Visual signs Visible loss of enamel. No visible sign of exposed dentin.
Percussion test Not tender. If tenderness is observed evaluate the tooth for a 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 risk of future healing complications. A lack of response at the initial examination indicates an increased risk of later pulp necrosis.
Radiographic findings The enamel loss is visible.
Radiographs recommended Periapical, occlusal and eccentric exposures. They are recommended in order to rule out the possible presence of a root fracture or a luxation injury.

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.