Tooth fractures: Enamel-dentin-pulp fracture

Definition and clinical appearance

Enamel-dentin-pulp fracture

A fracture which involves enamel and dentin, exposing the pulp. There is a substantial loss of tooth substance.

Another term for enamel-dentin-pulp fracture is “complicated crown fracture”.

 

Different sizes of pulp exposure

The area of pulp exposure influences the choice of treatment 

  1. A small exposure of vital pulp tissue
  2. A larger exposure of vital pulp tissue
  3. Exposure of ischemic pulp tissue

Clinical findings

Incisor with enamel-dentin-pulp fracture

The crown fracture shows exposed pulp tissue that may present itself in the centre as a small red spot or a regular bleeding structure.

Clinical photograph shows two incisors, both with enamel-dentin-pulp fracture.

Incisor with enamel-dentin-pulp fracture

Radiographic findings

Complicated crown fractures of maxillary central incisors

X-ray shows complicated crown fractures of maxillary central incisors involving enamel, dentin and pulp.
Lost tooth substance is apparent with exposure of the pulp. It should be verified that there is no root dislocation, root fracture, or other pathology.

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v1.0 2009-12-03