Authors of section

Editors

J Andreasen, CP Cornelius, N Gellrich, S Hillerup, K Kusumoto, W Schubert

Executive Editors

Edward Ellis III, Kazuo Shimozato

General Editor

Daniel Buchbinder

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Tooth fracture, pulp exposure

Definition and clinical appearance

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”.

Enamel-dentin-pulp fracture

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
Different sizes of pulp exposure

Clinical findings

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
Incisor with enamel-dentin-pulp fracture

Radiographic findings

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.

Complicated crown fractures of maxillary central incisors