Pediatric Dentistry · patient case question
How are the fractures of the permanent incisors classified?
Patient case: Basketball injury in a mixed dentition
Patient: 7-year-old boy brought in by his father one hour after an accident.
Chief complaint: Broke his front teeth playing basketball.
History: Struck in the mouth by an elbow. No loss of consciousness, no vomiting, no headache. Immunizations reportedly up to date but the father is unsure about the last tetanus booster.
Findings: Bleeding from the gingival margin and a lacerated lower lip. Fractures of two permanent maxillary incisors involving enamel and dentin with no pulp exposure; both respond within normal limits. A primary maxillary central incisor is luxated and grade 3 mobile. Radiographs show the tooth close to exfoliation with the permanent successor nearly erupted.
Show answer and explanation
Correct answer: A. Ellis Class II — enamel and dentin, no pulp exposure
- A. CORRECT. Ellis Class II is an uncomplicated crown fracture through enamel AND dentin with the pulp not exposed. Exposed dentinal tubules mean sensitivity and a route for bacterial ingress, so the dentin must be sealed promptly.
- B. Class IV describes a tooth that has lost vitality following trauma, with or without crown loss.
- C. Class III involves a frank pulp exposure — a visible pink or bleeding point.
- D. Class I is confined to enamel, typically an incisal chip with no dentin showing.
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