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Ellis & Daveyś Classification of Tooth Fracture - Conditions For Root Canal Treatment

By Dr. Osvaldo Estevam ,DDS


Fractures

Dental fractures can occur for various reasons: from children playing on the playground to adults trying to open bottles of drinks with their teeth or pressure on the teeth from habits like grinding or bruxism.

There are cases where a filling might be too large resulting in weakened integrity of the tooth.

Teeth may become fractured due to trauma to the teeth and supporting structures by injury as a result of a sudden impact to the face or head caused by a fall, fight, car accident or through involvement in contact sports where no mouthguard is worn.

Chewing or biting hard foods, such as bones, ice, nuts, or hard candy can also cause the teeth to get fractured.


Listed below are 4 typical types of Tooth Fractures

From the images you can see that the higher the number, the greater the difficulty in treating them.


Type 1. Affecting only enamel

This can be resolved with a simple resin restoration.




Type 2. Affecting enamel and dentin. Here it can also be resolved with resin(filling), but it may be necessary to apply a protective material over the dentin , since the fracture is close to the pulp.



Type 3. Affecting dentin enamel and pulp

This may require endodontic treatment (root canal treatment), but depending on the age of the patient, treatment can be attempted without removing the pulp. In these fractures it may be necessary, after root canal treatment if this is indicated, a pin restoration.


Type 4. Affecting enamel, dentin, pulp and root cement

In this case there may be a need to remove the element. There are treatments that involve the use of orthodontics for traction and then rehabilitation. In these situations, most cases require the use of intraradicular splinting or retainers.