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Enamel-dentine fracture is a complete fracture of the tooth enamel and dentine without the exposure of the pulp. Pulp sensibility testing is recommended to confirm pulpal health. Treatment depends on how close the fracture is in relation to the pulp.
An enamel fracture occurs when the outer layer of the tooth, known as enamel, is fractured without directly impacting the underlying tooth tissues of the dentine or pulp. [1] This phenomenon typically arises from hard, external forces impacting the tooth to induce enamel breakage. [ 1 ]
More than 75% of tooth fractures occur in the upper jaw, with the majority affecting the anterior teeth—particularly the central incisors, followed by the lateral incisors and canines. This trend highlights the vulnerability of these teeth to trauma, often resulting in enamel infractions or more extensive fractures. [15]
In extreme cases (such as a vertical fracture), tooth may need to be extracted 6–8 weeks: clinical and radiographic examination 1 year: clinical and radiographic examination 6) Crown-root fracture with pulp Involvement Fracture involving enamel, dentine and cementum with pulp exposure Tender tooth with mobile crown fragment
However, they have been noted to be an important potential source of enamel fractures that arise after extended use or overloading. [8] It appears that, although enamel easily starts to form the fracture defects of enamel tufts, they then enable enamel to resist the further progress of these fractures, ultimately preventing mechanical failure. [8]
It is suggested that these lesions are caused by forces placed on the teeth during biting, eating, chewing and grinding; the enamel, especially at the cementoenamel junction (CEJ), undergoes large amounts of stress, causing micro fractures and tooth tissue loss. Abfraction appears to be a modern condition, with examples of non-carious cervical ...
These forms of tooth wear can further lead to a condition known as abfraction, [3] where by tooth tissue is 'fractured' due to stress lesions caused by extrinsic forces on the enamel. Tooth wear is a complex, multi-factorial problem and there is often difficulty identifying a single causative factor. [3]
It has been proposed that the DEJ is crucial in preventing the progression of cracks from enamel to dentin and averting additional severe tooth fractures The dentino-enamel junction (DEJ) is an intricate biomechanical interface that forms the boundary between the highly mineralised enamel and the collagen-rich dentin.