Ellis’ classification:

l Class I: Simple fracture of

Management of Traumatic the crown involving little
or no dentin
l Class II: Extensive
Injuries fracture of the crown
involving considerable
dentin but not the pulp
l Class III: Extensive
fracture of the crown with
a pulpal exposure
l Class IV: A fracture in
which the entire crown
has been lost

Vitality tests after trauma Types of Injuries

l Ankylosis
¡ This is caused by injury to the
l Thermal test- most reliable, especially in primary periodontal membrane and
incisors, failure to respond to heat is indicative of pulpal subsequent inflammation
necrosis
¡ The ankylosed primary tooth in
l EPT- often unreliable the anterior segment should be
l Failure of a recently traumatized tooth to respond to the removed if there is evidence of
pulp test is common. it causing delayed or ectopic
l Emergency tx should be completed and the tooth eruption of the permanent
should be retested in 10-14 days. successor
l Darkening of the tooth is a good indication of loss of ¡ It is often detected by a “step”
with the ankylosed tooth below
vitality of the pulp.
the plane of occlusion.

l Luxation/Intrusion l Dilaceration
¡ Displaced but not intruded primary teeth should be ¡ This occasionally occurs
repositioned as soon as possible to prevent after intrusion or
interference of occlusion displacement injuries
¡ They can be stabilized with wire and composite ¡ The developed portion of
splint the tooth is twisted or
¡ Intruded teeth are left to spontaneously re-erupt bent on it self, and on this
¡ Severely loosened primary teeth should be removed new position growth
progresses
¡ The resulting tooth has
the crown in a
significantly different
position from the root

1
 l Avulsion
l Root Fractures
¡ The best prognosis is for teeth replanted within a short
¡ Root fractures at the apical half of the tooth are more period of time
likely to undergo repair often without treatment
¡ Teeth should not be cleaned, disinfected, rinsed, or
¡ In order for repair to take place, the fragments must scaled
be maintained in apposition
¡ The pt or parent can be instructed to replant the tooth,
¡ Healing should take place in 3-4 weeks or the tooth can be stored in milk or saliva
¡ Reimplanted teeth are treated endodontically later