Enamel Fracture — ORE Part 1 MCQ

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EasyRestorative DentistryEnamel FractureORE Part 1

A 7-year-old child attends after a fall. The upper left central incisor has an enamel-only crown fracture (Ellis Class I), with no dentine exposure. The tooth is vital and non-tender. What is the most appropriate management?

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Correct answer: E — Smooth sharp edges and restore if needed; arrange review

**A is correct.** An Ellis Class I injury is confined to enamel. In a vital, non-tender incisor with no dentine exposure, UK guidance supports conservative management: smooth sharp edges, restore with composite only if contour or aesthetics require it, and arrange follow-up after trauma. SDCEP specifically notes that, where dentine is not exposed, treatment may be required to remove sharp edges or restore aesthetics. NHS England similarly includes smoothing and simple composite build-ups within conservative management of uncomplicated crown fractures. **B** is unsafe because a sharp edge may traumatise lips, tongue or cheek, and follow-up remains appropriate after dental trauma. **C** is unjustified because the tooth is restorable and vital. **D** is reserved for pulp involvement, which is absent. **E** is excessive treatment for a small enamel-only fracture and is not the routine restoration for a permanent incisor.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Emergency Dental Care: Emergency Care in Practice, section 2.3.2, 2021. https://www.sdcep.org.uk/media/wfrjkqax/edc-guidance.pdf