Fracture management in dental treatment focuses on diagnosing and addressing fractures in teeth or the surrounding oral structures to restore functionality, aesthetics, and comfort. The approach depends on the type, location, and severity of the fracture.

Types of Tooth Fractures

1. Craze Lines: Small, superficial cracks in the enamel.
2. Enamel Fracture: Break limited to the enamel.
3. Enamel-Dentin Fracture: Extends into the dentin without pulpal involvement.
4. Enamel-Dentin-Pulp Fracture: Involves enamel, dentin, and the pulp chamber.
5. Root Fractures: Horizontal or vertical fractures of the tooth root.
6. Crown-Root Fracture: Involves the crown and root, possibly with pulpal exposure.
7. Alveolar Fractures: Involves the bone supporting the teeth.

Steps in Fracture Management

1. Assessment and Diagnosis

• Clinical Examination: Assess pain, mobility, and visible fracture lines.
• Radiographs: Take X-rays to evaluate the fracture’s extent and location.
• Vitality Testing: Check the tooth’s pulp vitality using thermal or electric tests.

2. Management Based on Fracture Type

1. Craze Lines

• No treatment usually required unless for aesthetic concerns.
• Cosmetic solutions: Polishing or composite resin bonding.

1. Enamel Fracture

• Smoothen sharp edges.
• Restore with composite resin for aesthetics.

1. Enamel-Dentin Fracture

• Bonding with composite resin.
• Indirect restoration (e.g., veneers, crowns) for larger fractures.

1. Enamel-Dentin-Pulp Fracture

• Young Teeth: Pulp capping or pulpotomy to preserve vitality.
• Mature Teeth: Root canal treatment followed by crown placement.

1. Root Fractures

• Apical Third Fractures: Monitor and stabilize if asymptomatic.
• Middle or Coronal Third Fractures: Splinting and possible endodontic treatment. Extraction may be necessary in severe cases.

1. Crown-Root Fracture

• Remove fractured fragment.
• Perform endodontic treatment if the pulp is exposed.
• Restore with post and core and crown.

1. Alveolar Fractures

• Reposition displaced segments and stabilize with splints.
• Soft diet and monitor healing.

Adjunctive Treatment

• Splinting: Temporary stabilization of fractured or mobile teeth using dental splints.
• Endodontics: Root canal treatment for fractures involving pulp exposure.
• Periodontics: Treat associated soft tissue injuries and ensure bone healing.
• Oral Surgery: Extraction of non-restorable teeth or repair of severe bone fractures.

Follow-Up and Maintenance

• Regular check-ups to monitor healing and function.
• Reinforce oral hygiene to prevent secondary issues.
• Use protective measures like mouthguards for bruxism or sports.

Early diagnosis and timely management are essential to prevent complications and maintain oral health.