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Dental Trauma

Dental Trauma: Ellis Classification & Simple Management Guide

An easy, examiner-friendly breakdown of Ellis fracture classification and treatment.

Quick Answers

What is the Ellis classification?

A simple system categorizing traumatic crown fractures from enamel-only to pulp-exposed injuries.

Which Ellis class exposes dentin?

Class II.

Which Ellis class exposes pulp?

Class III.

What is the first exam step in trauma?

Rule out other injuries → check mobility → test vitality → take appropriate radiographs.

1. Why Ellis classification is always in exams

Because it is fast, universal, clinically relevant, and helps guide emergency management.

Examiners expect you to:

  • identify the class quickly,
  • give immediate management,
  • explain long-term follow-up.

2. Ellis Class I — Enamel fracture

Features

  • Only enamel involved
  • No dentin exposed
  • No sensitivity

Management

  • Smooth sharp edges
  • Composite restoration if needed
  • Routine follow-up

3. Ellis Class II — Enamel + dentin fracture

Features

  • Dentin exposed (yellow-ish)
  • Sensitivity to cold/air
  • Risk of pulp infection if untreated

Management

  • Cover dentin with calcium hydroxide or glass ionomer
  • Restore with composite
  • Vitality + radiograph follow-up

4. Ellis Class III — Enamel + dentin + pulp exposure

Features

  • Pulp visible (pink/red)
  • Bleeding from exposure site

Management

  • Young patients: pulp capping or partial pulpotomy (best outcomes)
  • Adults: pulpotomy or RCT depending on tooth maturity
  • Immediate coverage to prevent contamination

5. Ellis Class IV — Pulp-necrotic tooth after trauma

Features

  • Darkened tooth
  • Non-vital on EPT/cold testing
  • History of previous trauma

Management

  • Root canal treatment
  • Internal bleaching for aesthetics

6. Radiographs: what examiners want

You must mention these three:

  • Periapical for root + periapex
  • Occlusal for alveolar fractures
  • Soft-tissue radiograph if fragments suspected in lip

7. OSCE-style model answer

Model Examiner Answer

“This injury is consistent with an Ellis Class II fracture, as dentin is exposed. My emergency management is to seal exposed dentin with a liner, restore with composite, and review vitality over the next weeks to monitor for pulp changes.”

8. Common mistakes students make

  • Not checking for lip fragments
  • Ignoring vitality tests
  • Not covering exposed dentin immediately
  • Choosing RCT too early in Class III cases

9. How DentAIstudy helps

DentAIstudy AI can instantly generate:

  • Trauma OSCE scripts
  • Management flows
  • Vitality decision guides
  • One-page trauma notes

Try Study Builder →

References

  • Andreasen JO, Andreasen FM. Textbook and Color Atlas of Traumatic Injuries to the Teeth.
  • IADT Guidelines for Dental Trauma 2020.
  • Bourguignon C, et al. “International Association of Dental Traumatology Guidelines Update.”