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Wednesday, February 6, 2013

Classification of Dental Trauma

Fig. 1  Dental Trauma

Traumatic force to the teeth or periodontium can cause destruction in a variety of direction and of a variety of magnitudes. Traumatic injuries often occur. For the sake of clarity, however, each type of injury will be describe individually.

The classification  of dental trauma used is based on the World Health Organization (WHO) classification of diseases and has been modified according to Andreasen's recommendation.

Enamel Infraction and Fracture

An incomplete fracture of the enamel without an enamel defect (crack) is called an infraction (Fig. 1-1a). An enamel fracture is a small chip of enamel only (Fig. 1-1b).

Fig. 1-1a  Enamel infraction
Fig. 1-1b  Enamel fracture

 Crown Fracture Without Pulpal Involvement

This type of crown fracture involves only enamel and dentin with no direct pulp exposure (Fig. 1-1c).

Fig. 1-1c  Crown fracture without pulpal involvement

Crown Fracture With Pulpal Involvement

This fracture involves enamel, dentin, and direct exposure of the pulp (Fig. 1-1d).

Fig. 1-1d  Crown fracture with pulpal involvement

Crown-root Fracture

This fracture involves enamel, dentin, and cementum, and may or may not involve pulpal exposure (Fig. 1-1e).

Fig. 1-1e  Crown-root fracture

 Root Fracture

This fracture involves dentin, cementum and pulp (Fig. 1-1f). Special attention is required because root fracture and luxation injury may occur simultaneously.

Fig. 1-1f  Root fracture


Concussion is a minor injury of the periodontium with no displacement of the tooth nor mobility (Fig. 1-1g).

Fig. 1-1g  Concussion


Subluxation is an injury of the periodontium without displacement of the tooth but with slight mobility. Damage to the blood supply of the pulp and the periodontium is usually minor, but pulpal problem occasionally result (Fig. 1-1h)

Fig. 1-1h  Subluxation

Extrusive Luxation

This injury is displacement of the tooth in an extrusive direction involving the periodontal support and the pulpal blood supply (Fig. 1-1i)

Fig. 1-1i  Extrusive luxation

Lateral Luxation

The tooth is displaced from its long axis, usually with the apical end displaced labially and the coronal part palatally. The pulpal blood supply is usually completely severed (Fig. 1-1j)

Fig. 1-1j  Lateral luxation

Intrusive Luxation

This most serious of luxation injuries results in the tooth being displaced apically, leading to a crushing of the neurovascular bundle entering the pulp and severe damage to the cementum and periodontium (Fig. 1-1k)

Fig. 1-1k  Intrusive luxation


An avulsed tooth is completely displaced from the alveolus with total disruption of the pulpal blood supply (Fig. 1-1l)

Fig. 1-1l  Avulsion

Soft Tissue Injury and Fracture of Alveolar Bone

Soft tissue injury involves the gingiva, oral mucosa, and lips. Fractures involve the alveoli and the jaw bones.

Reference : Tsukiboshi, M. 2000. Treatment Planning for Traumatized Teeth. Quintessence Publishing Co, Inc. Japan

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