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An enamel fracture is when the outermost layer of the tooth is cracked, without damaging the inner layers including the dentine or pulp. This can happen from trauma such as a fall where the teeth are impacted by a hard object causing a chip to occur. Enamel fracture of tooth 11 on the incisal, biting, surface
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. If a tooth fragment is available, it can be bonded to the tooth.
Trauma to primary teeth occurs most commonly at the age of two to three years, during the development of motor coordination. [7] When primary teeth are injured, the resulting treatment prioritises the safety of the adult tooth, [7] and should avoid any risk of damaging the permanent successors. [8]
Intraorally, if the fracture occurs in the tooth bearing area, a step may seen between the teeth on either side of the fracture or a space can be seen (often mistaken for a lost tooth) and bleeding from the gingiva in the area. There can be an open bite where the lower teeth, no longer meet the upper teeth.
Root fracture of the tooth is a dentine cementum fracture involving the pulp. Traumatic root fracture occurs most often in the middle third of the roots of fully erupted and fully formed teeth. However, root treated teeth are more susceptible to root fracture, as this involves removing root dentine, thereby weakening the tooth.
Vertical root fractures represent between 2 and 5 percent of crown/root fractures. The greatest incidence occurs in endodontically treated teeth, and in patients older than 40 years of age. The occurrence of a complete vertical root fracture is often catastrophic for the individual tooth as tooth extraction is usually the only reasonable treatment.
Cracked tooth syndrome could be considered a type of dental trauma and also one of the possible causes of dental pain. One definition of cracked tooth syndrome is "a fracture plane of unknown depth and direction passing through tooth structure that, if not already involving, may progress to communicate with the pulp and/or periodontal ligament ...
[10]: 24 The term is falling into disfavor and has given way to the more generalized description of fractures and cracks of the tooth, which allows for the wide variations in signs, symptoms, and prognosis for traumatized teeth. A fracture of a tooth can involve the enamel, dentin, and/or pulp, and can be orientated horizontally or vertically.