IADT treatment guidelines for enamel-dentin fracture

crown-fracture-emanel-dentin4

Clinical findings

  • A fracture confined to enamel and dentin with loss of tooth structure, but not exposing the pulp.
  • Percussion test: not tender. If tenderness is observed, evaluate the tooth for possible luxation or root fracture injury.
  • Normal mobility.
  • Sensibility pulp test usually positive.

Radiographic findings

  • Enamel-dentin loss is visible.
  • Radiographs recommended: periapical, occlusal and eccentric exposure to rule out tooth displacement or possible presence of root fracture.
  • Radiograph of lip or cheek lacerations to search for tooth fragments or foreign materials.

Treatment

  • If a tooth fragment is available, it can be bonded to the tooth. Otherwise, perform a provisional treatment by covering the exposed dentin with glassIonomer or a more permanent restoration using a bonding agent and composite resin or other accepted dental restorative materials.
  • If the exposed dentin is within 0.5 mm of the pulp (pink, no bleeding), place calcium hydroxide base and cover with a material such as a glass ionomer.

Follow-up

  • 6-8 weeks – Clinical and radiographic examination.
  • 1 year – Clinical and radiographic examination.