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Ellis Fractures
Ellis Fractures
Karishma Ashok
Guided By:
Dr Sumedh Khare
Class I: Simple fracture of crown invoving little or
no dentin
Class II: Extensive fracture of crown involving
considerable dentin but not the dental pulp
Class III: Extensive fracture of crown involving
considerable dentin and exposing the dental pulp
Class IV: Traumatised teeth that has become non-
vital with or without loss of tooth structure
Class V: Teeth lost as a result of trauma
Class VI: Fracture of root with or
without loss of crown structure.
Class VII: Displacement of a tooth
without fracture of crown or root.
Class VIII: Fracture of crown en
masse and its replacement
Class IX: Traumatic injury to
primary teeth
ETIOLOGY
1. Fall
2. Accidents
3. Sports
4. Battered child syndrome
5. Assaults
1. Children with accident prone facial profile
(a) Increased overjet with protrusion of upper incisors &
insufficient lip closure
(b) Angle’s Class II type 1 malocclusion
(c) Angle’s Class I type 2 malocclusion
2. Children with cerebral palsy
This is due to:
(a) Abnormal muscle tone & function resulting in
maxillary anterior protrusion
Poor skeletal & muscle co-ordination
3. Dentinogenesis Imperfecta
It is the term used to describe the complete
displacement of tooth from its alveolus. It is called
EXARTICULATION .
Maxillary teeth most commonly
affected.
Age group:7-9 years
(loosely structured pdl &
low mineralisation..hence
minimal resistance to
extrusion)
Bleeding socket with missing tooth
RADIOGRAPHIC FEATURES
Empty socket
Associated bone fractures
If the wound is recent then lamina dura is visible,
otherwise obliterated
Re-implantation
Avulsed tooth with open apex – Endontic therapy is
delayd till first signs of apical closure are seen
Avulsed tooth with closed apex – Endodontic therapy
is done after 1-2 weeks depending on the type of re-
implantation
The single most important factor in the success of re-
implantation is the speed with which the tooth is re-
implanted. Every effort should be made to re-implant the
tooth within first 15-20 minutes.
1. Reimplantation of a
tooth with completed
apex
2.Rinsing the tooth
with saline
3. Reimplantation
using slight
finger pressure
4. splinting
1. Check the alveolar socket. It should be reasonably
intact in order to provide a seat for the avulsed tooth.
2. The extra-alveolar period
3. Socket is gently rinsed with saline when it is clear of
the clot & debris its walls are examined for presence,
absence or collapse of socket wall
4. Palpitation of socket & surrounding apical areas is
done to know if an alveolar frcture is present in
addition to avulsion
5. Radiograph is taken
6. Preparation of root
7. Preparation of Socket
8. Splinting
Adjunctive Therapy
A recent study reveals that systemic antibiotics given at
the time of re-implantation & prior to endodontic
treatment are effective in preventing bacterial invasion
of necrotic pulp & therefore subsequent inflamatory
response.
Home Care
Since adequate brushing is difficul, mouth rinsing is
advised. The patient should not bite on splinted
teeth and should be advised soft diet.
CONTRAINDICATIONS
After 3 days
Proliferating
connective tissue
After 2 weeks
new collagenous
Fibres formed
Normal state
Restored(8 mnths)
ii. Healing with surface resorption:
COMPLICATIONS:
If not treated, may lead to migration of adjacent teeth.
Either re-implantation or space maintaince using
orthodontic appliance is indicated.