Tooth fractures can be quite different depending on the size and location of the fracture lines. They are the result of a trauma in sports, during playing, falling, biting solid food (front teeth), and especially common in teeth with thin walls due to endodontic treatment. Tooth fractures are different and may affect only the enamel, the enamel and a part of the dentine, or the nerve of the tooth. In some cases, there might occur fracture of the tooth root located at different depth in the bone. Depending on the depth and direction of the fracture there may be symptoms (pain, tooth loosening) or no symptoms.

Tooth fracture of the enamel/ Tooth fracture of the enamel, dentin and affecting the nerve

The small and superficial fractures of the enamel are characterized by a lack of pain or weak sensitivity. There is only a cosmetic problem with the appearance of the tooth because of the missing piece. In more complex fractures, where the dentine is involved, there is pain, which can be spontaneous or provoked. If the nerve of the tooth is affected, the pain is unbearable even by inhalation of cold air and there may be a slight bleeding from the place of the open nerve. In some cases the only symptom of fracture can be movement of a part of the tooth during chewing. In the case of fractures in the neck of the tooth, the entire crown breaks off and only the root remains in the gum. This type of fractures occurs most often with improperly made crowns and in severe sport injuries.

Very often vertical fractures of the teeth can be seen. They extend through the crown and the root of the tooth and the tooth is split lengthwise in one or several pieces. This type of fractures occurs most often after endodontic treatment of the tooth (removing of the tooth nerve) and in many cases leads to loss of the tooth.

Vertical fractures of the crown and the root of the tooth

In sports injuries there may occur breakage of the root of the tooth at different depths into the bone. In some cases fractured roots cannot be diagnosed through routine dental check-up, so an X-ray picture of the suspected tooth is required. In fractures of the tooth crown, where there is no displacement of fragments, colouring with special dyes is used to show the size of the fracture line.
For small cracks in the enamel and dentine, photopolymer fillings are used to restore the defect with which the function and aesthetic appearance recover completely.
For larger fractures in the dentine, a follow-up of the tooth is required – in severe injury it is possible that the tooth dies on its own. Depending on whether the tooth remains alive or not, further treatment is carried out.
In fractures with the involvement of dental pulp (nerve), endodontic treatment is carried out before restoring the tooth.

In fractures in the neck of the tooth where the entire crown is missing, root canal treatment is carried out, then a metal or glass fiber pin is placed in the root canal, which is followed by the preparation of the tooth and a crown.

In the worst cases – an infection, inability to treat and vertical fractures, the tooth is removed.

Teeth which have survived the fracture treatment, must be followed up at 20 days, 3 and 6 months to see if the tooth is still alive.

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