how can we save a fractured tooth?
If a patient comes with a fractured tooth. You have few options to treat it. Treatment for the fractured tooth is depended on the extend of the fracture.
There are many classifications by different authors.
Ellis Classification is commonly used.
• Class 1: Simple fracture of crown, involving little or no dentin.
• Class 2: Extensive fracture of crown, involving considerable dentin, but no dental pulp.
• Class 3: Extensive fracture of crown, involving considerable dentin and exposing pulp.
• Class 4: The traumatized tooth becomes non vital with or without loss of crown structure.
• Class 5: Tooth lost as a result of trauma.
• Class 6: Fracture of root with or without fracture of crown.
• Class 7: Displacement of tooth without fracture of crown or root.
• Class 8: Fracture of crown enmasse.
• Class 9: Traumatic injury to deciduous tooth.
How to manage:
Ellis I fracture: Smooth rough corners with a dental drill or an emery board. Treatment of fractures contained solely within the enamel alone requires no urgent care. The tooth can be repaired cosmetically at the convenience of the patient
Ellis II fracture: Cover exposed dentin with a layer of zinc oxide or calcium hydroxide paste (Dycal). Dycal requires the tooth to be absolutely dry for adherence. Cover the tooth with a small piece of dental or aluminum foil. Exposure to humidity increases the rate at which the Dycal will set. In patients younger than 12 years, coverage is especially important to prevent infection.
Ellis III fracture: Cover exposed dentin with a layer of zinc oxide or calcium hydroxide. Bleeding and moisture with this type of fracture usually makes it more difficult for these materials to adhere to the tooth. Cover with dental foil and expediently refer the patient to a dentist.
Root and dentoalveolar fractures require splinting for several weeks.
Bone wax (Ethicon), which is a combination of beeswax and isopropyl palmitate, is not recommended for open dental fractures because it can cause inflammatory reactions of the surrounding soft tissues (eg, pulp).
Saving a fractured tooth is all about preventing further infection. If we succeed in that the tooth will survive.