Online Dental Trauma Guide: Part I Fracture Injuries
Infractions
Infractions
Infraction is an incomplete fracture (crack line) of the enamel without loss of any tooth structure.
Clinical findings
A tooth with an infraction:
Is usually asymptomatic
May be sensitive to cold air and touch.
It is important to rule out any associated luxation/ displacement or root fracture injuries.
Illustration: Longitudinal section of a tooth showing an infraction injury.
Clinical image: Infractions of the UL1.
Radiograph: UL1 with no visible sign of the infraction injuries and a normal periodontal ligament space.
Radiographic findings
A radiograph will show:
A normal appearance
No change in the periodontal ligament space.
Management of primary teeth
Infractions in primary teeth should be monitored with no need for active intervention.
Management of permanent teeth
No active treatment usually necessary.
In cases of extreme sensitivity consider etching and sealing with unfilled resin.
If aesthetics is a concern, then creating a small channel using a small round diamond bur and sealing with composite resin may seal the crack line, improve the appearance and satisfy the patient.
In extreme cases with multiple infractions, a labial composite veneer to seal the infractions and ‘splint’ the fragments together may be sensible.
Monitoring: A one year follow-up period is advised as part of routine care.