Ellis Class II Management — ORE Part 1 MCQ

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EasyRestorative DentistryEllis Class II ManagementORE Part 1

A permanent maxillary incisor has an uncomplicated crown fracture involving enamel and dentine only. There is no pulp exposure, displacement or abnormal mobility. What is the most appropriate management?

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Correct answer: D — Protect the exposed dentine and provide a definitive adhesive restoration

Explanation lettering: B = shown as A · E = shown as B · A = shown as D · D = shown as E

This is an uncomplicated enamel-dentine crown fracture: dentine is exposed but there is no pulp exposure. The exposed dentine should be protected and the tooth definitively restored, usually with an adhesive composite restoration; the fractured fragment may be rebonded if available. Follow-up assessment of pulpal status is appropriate after trauma. SDCEP advises that enamel-dentine fractures of permanent teeth require urgent assessment and that lost permanent tooth structure should be restored or the fragment rebonded. B leaves exposed dentine untreated. C is inappropriate for a restorable permanent tooth. D is not indicated without evidence of pulpal disease or necrosis. E may be a short-term first-aid measure but is not definitive management.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems: Injuries to the mouth, face and jaws, current webpage. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/less-common-oral-conditions/injuries-to-the-mouth-face-and-jaws/