TRAUMATIC

INJURIES TO
PRIMARY
DENTITION

CROWN FRACTURE
ENAMEL INFRACTION

Enamel Infraction is an incomplete fracture (crack) of the enamel

without the loss of tooth structure

Clinical features :

Visible fracture lines on the surface of the tooth

No signs of tenderness/ mobility

Transillumination can help detect enamel infraction

No need for treatment / follow-up unless associated with luxation injuries (in
which case tooth will show signs of tenderness)

ENAMEL FRACTURE

An uncomplicated fracture confined to enamel with loss of tooth

structure

Clinical findings :

Visible loss of tooth structure involving the enamel only

No signs of tenderness/ mobility

Management :

Smoothening of sharp edges with a bur

Fluoride application
Composite restoration

ENAMEL & DENTIN FRACTURE

An uncomplicated crown fracture involving the enamel and dentin but

not exposing the pulp

Clinical features :

Visible fracture involving the enamel and dentin

No signs of exposed pulp tissue / tenderness / mobility

The dentin tubules are exposed and hence must be sealed with Calcium
hydroxide / GIC lining with composite to prevent any further mechanical /
thermal / chemical insult to the pulp
Radiographs may reveal
the size of pulp chamber
(pulp) proximity to the fracture line

 the stage of root development

the degree of primary root resorption

Management :

Sealing of dentinal tubules

If the fractured segment is recovered, re-attachment is possible
Composite restoration
In case of extensive tooth structure loss full coverage restorations
can be given
Stainless steel crown (SSC)
Open faced / Resin veneered SSC
Polycarbonate crowns
Strip crowns

ENAMEL-DENTIN-PULP FRACTURE

A complicated crown fracture involving the enamel, dentin and

exposing the pulp

Clinical features :

Visible fracture involving the enamel and dentin with pulpal exposure

Management :

Direct pulp capping

Partial pulpotomy

Pulpectomy
Extraction