Dental Trauma: Ellis Classification

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Ellis Classification of Dental Fractures
Ellis I
Includes crown fractures that extend only through the enamel.
Teeth are usually nontender, and without visible color change, but have rough edges.
Ellis II
Fractures that involve the enamel and dentin layers.
Teeth are typically sensitive to cold, hot, touch and/or air exposure. A yellow layer of dentin may be visible on examination
Ellis III
Involve the enamel, dentin, and pulp layers.
Teeth are extremely sensitive, and have a visible area of pink, red, or even blood at the center of the tooth. 
The pulp of the tooth is very prone to infection. Infection of the pulp is termed pulpitis and can lead to potential tooth loss. The dentin of the tooth is very porous and is an ineffective seal over the pulp. In Ellis II and III fractures in which the dentin or pulp is exposed, the clinician caring for the tooth fracture in the acute setting must create a seal over these injured teeth to protect the pulp from intraoral flora and potential infection.
Other dental injuries that may or may not be associated with a dental fracture include the following:
  • Dental avulsion - Complete extraction of the tooth (crown and root)
  • Dental subluxation - The loosening of a tooth following trauma
  • Dental intrusion - The forcing of an erupted tooth below the gingiva
In these situations, the goal is to return the tooth to its correct anatomical position as quickly and securely as possible, without causing further trauma to the tooth, gingiva, or alveolar bone.