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Tooth Fracture (Classification and Treatment)

Ellis classification and modern management: emergency intervention and esthetic restoration

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Tooth Fracture (Classification and Treatment)?

Tooth fracture is most common in young (8-12 years) and adolescents; sports injuries, falls, traffic accidents, fights are the main causes. Annual prevalence reaches 1-3% in adolescents. Maxillary central incisor is the most affected (80%); upper protruding teeth (overjet >6 mm) are at increased risk.

Ellis classification: Class I (enamel only fracture), Class II (enamel + dentin, no pulp exposure), Class III (enamel + dentin + pulp exposure), Class IV (root fracture), Class V (avulsion - tooth completely out), Class VI (radicular fracture). Andreasen classification is used for more detailed clinical decision.

Emergency intervention: pulp exposure → pulp cap (Cvek pulpotomy) within 1 hour, ideally direct pulp cap; for avulsion → tooth replantation within 30 minutes (extraoral time critical), milk-saline preservation. Long-term prognosis: tooth vitality, root development (apexogenesis), endodontic treatment, esthetic restoration (composite, veneer, crown). Mouthguard reduces risk by 60% in young athletes.

Symptoms

Tooth pain (severe in pulpal involvement)
Cold-hot sensitivity (dentin exposure)
Visible tooth fracture or chip
Mobility (root fracture)
Bleeding gums (especially periodontal involvement)
Lip-tongue laceration accompanying fracture

Risk Factors

Young age (8-12 years)
Sports activity (especially boxing, basketball, hockey)
Overjet >6 mm (upper protruding teeth)
Class II malocclusion
Inadequate lip protection
Mouthguard non-use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Tooth fracture/chip after trauma
  • Severe tooth pain, especially with pulp exposure
  • Tooth completely out (avulsion - 30 minutes critical)
  • Tooth mobility or root fracture
  • Lip-tongue laceration
  • Sports injury followed by tooth pain

Treatment Methods

01
Class I: composite restoration (enamel reshaping)
02
Class II: composite restoration + dentin protection
03
Class III: pulp cap (Cvek) + restoration or root canal treatment
04
Class IV: splint + endodontic treatment
05
Class V (avulsion): replantation in 30 min + splint + endodontic
06
Class VI: extraction + implant/bridge restoration

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Diş çürüğü, ağız bakterilerinin şekeri fermente ederek ürettiği asitlerin diş minesi, dentin ve pulpayı tahrip etmesiyle oluşan kronik bir hastalıktır.

Diş Eti Hastalıkları (Periodontal Hastalıklar)

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Periodontal hastalıklar, diş eti (gingivit) ve diş çevresindeki kemik ile bağ dokusunun (periodontit) bakteri kaynaklı iltihabıdır; tedavi edilmezse diş kaybına neden olur.

Impacted Tooth

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An impacted tooth — most often a wisdom tooth — has not erupted fully and remains in the jaw bone or gum. It can lead to pericoronitis, caries and cysts.

Dental Implants

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A dental implant is a titanium screw placed in the jawbone that supports a crown, bridge or denture, providing the closest possible function and aesthetics to a natural tooth.

Teeth Whitening

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Teeth whitening lightens tooth color using hydrogen peroxide or carbamide peroxide gels. In-office (professional) bleaching uses higher concentrations with light activation for faster results; home bleaching uses custom trays with lower concentrations over 1–4 weeks. Safety depends on healthy teeth, correct concentration, isolation of gums and transient sensitivity management.

Orthodontics

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Orthodontics is the dental specialty that corrects the alignment of the teeth and jaws, providing both aesthetic and functional benefits at any age, from childhood through adulthood.

Gingival Recession (Gum Recession)

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Gingival recession is the apical displacement of the gingival margin with exposure of the root surface. It may be localized or generalized and results from mechanical trauma, periodontal disease, thin biotype or anatomic factors. Recession can cause root sensitivity, caries and aesthetic concerns; management includes cause elimination and surgical root coverage when indicated.

Bad Breath (Halitosis)

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Halitosis is a chronic problem that affects a substantial part of the population. It is most often of oral origin and can interfere with social interactions.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.