Oral Surgery · patient case question
The full-thickness tear with irregular edges on the inner surface of the lower lip is best classified as which type of injury?
Patient case: Face-First Fall on Concrete
Patient: 34-year-old male
Chief Complaint: “I tripped and landed on my face on the sidewalk.”
Background: Healthy. No loss of consciousness, no nausea, no visual disturbance. Tetanus status current. Injury occurred approximately 5 hours ago.
Medications: None
Vital Signs: BP 128/78 mmHg · HR 84 bpm · RR 16 · T 98.4°F
Findings: Chin shows a broad, raw, superficially scraped area with punctate bleeding and embedded grit. The inner surface of the lower lip has a full-thickness tear with irregular edges. Teeth #7 and #8 are fractured with frank pulp exposure, tender to percussion, mature apices. Tooth #6 is intact, non-mobile, responds normally to cold, with no radiographic changes.
Show answer and explanation
Correct answer: D. Laceration
- A. Incorrect. Ecchymosis is a flat area of submucosal or subcutaneous hemorrhage with an intact surface — a bruise, not a tear.
- B. Incorrect. An abrasion is superficial epithelial loss without a full-thickness breach, which is what is present on the chin rather than the lip.
- C. Incorrect. An aphthous ulcer is a recurrent immune-mediated ulceration with a yellow-gray pseudomembrane and an erythematous halo. It is unrelated to trauma and would not appear acutely after a fall.
- D. Correct. A laceration is a tear extending through the full thickness of the tissue, produced when soft tissue is crushed against the teeth. Ragged edges are typical, and the wound must be explored for tooth fragments before closure.
Note: Always radiograph the lip when a tooth fragment is unaccounted for. A soft tissue view with reduced exposure will reveal embedded enamel or dentin fragments that would otherwise cause chronic infection.