Frequency of Elli’s Class 4 Fracture in Males and Females Aged 10-17 Years

M. Dhakshinya

Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.

Vignesh Ravindran

Department of Pedodontics and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.

*Author to whom correspondence should be addressed.


Introduction: Children nowadays are exposed to the world from a much earlier age than their forefathers, rendering them more vulnerable to multiple trauma risk factors such as falls, injuries, peer battle, and so on. Depending on where the tooth is fractured, different physical and clinical findings are present. Take note of the extent of the fracture as well as the patient's age. For obvious fractures, the Ellis classification was created. Ellis 4 fractures leads to non vitality of a tooth.

Materials and Methods: Data was collected from the patient who visited the outpatient of a private dental institution and following parameters like gender, Children with elli’s class 4 fracture in the age group of 10-17 years was recorded. 47 patient details were analyzed between September 2022 to December 2023 which fulfilled the inclusion and exclusion criteria were included in the study. This data was statistically analyzed using SPSS version 23.

Results: Predominantly 74.47% of males and 25.53% of females had ellis class 4 fracture in relation to the tooth number 11 i.e upper right central incisor. An attempt was made to collect data in a prospective manner and to include a wide range of ages in the population. Only 38.30% of the patients belonged to the age group of 14-17 years. 53.19% of the Ellis class 4 fractures happened only after the root formation was completed. Most patients with Ellis class 4 (Non vital) had fracture seen in their teeth which was Ellis class 1 fracture which only involves the enamel (44.68%).

Conclusion: So, from our study we can conclude that ellis class 4 fracture was predominantly seen in tooth number 11 which was around 53.19% and males were most affected which was around 74.47%.

Keywords: Dental trauma, elli’s class 4 fracture, endodontists, root canal treatment, tooth coloured restorations, innovative

How to Cite

Dhakshinya, M., and Vignesh Ravindran. 2024. “Frequency of Elli’s Class 4 Fracture in Males and Females Aged 10-17 Years”. Asian Journal of Dental Sciences 7 (1):22-31.


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Andreasen JO, Lauridsen E, Gerds TA, Ahrensburg SS. Dental trauma guide: A source of evidence-based treatment guidelines for dental trauma [Internet]. Dental Traumatology. 2012;28:142–7. Available:

Andreasen JO, Ahrensburg SS. History of the dental trauma guide [Internet]. Dental Traumatology. 2012;28;336–44. Available:

Kandamani J, Gouthaman SS, Ramakrishnan DS, Kumar MPS, Muthusekar MR. Evaluation of effect of submucosal administration of depomedrol in management of postoperative sequelae in mandibular fractures: A randomized clinical trial study. Natl J Maxillofac Surg. 2022;13(1):84-9.

ADHD and dental trauma [Internet]. Dental Abstracts. 2010;55:333–4. Available:

Eden E, Buldur B, Duruk G, Ezberci S. Web-based dental trauma database using Eden Baysal dental trauma index: a turkish multicenter study [Internet]. European Oral Research; 2021. Available:

Welbury RR, Gregg TA. Managing dental trauma in practice. Quintessenz Verlag. 2019;124.

Andreasen JO, Bakland LK, Flores MT, Andreasen FM, Andersson L. Traumatic dental injuries: A manual. John Wiley & Sons. 2011;104.

Khan SD, Assiry AA, Al Yami SM, Al Makrami MH, Al Milaq FH, Al Hareth IS, et al. Assessment of knowledge and attitudes of school teachers regarding emergency management of an avulsed permanent tooth of Southern Region of Saudi Arabia. Int J Clin Pediatr Dent. 2020;13(6):644–9.

Institute NC, National Cancer Institute. Tooth Fracture [Internet]. Definitions; 2020. Available:

Bhat SV, Krishna VK, Periasamy S, Kumar SP, Krishnan M. Modified retromandibular approach for the management of condylar fractures of the mandible. Cureus. 2022;14 (8):e27697.

Van Valkenburgh B, White PA. Naturally-occurring tooth wear, tooth fracture, and cranial injuries in large carnivores from Zambia [Internet]. PeerJ. 2021;9:e11313. Available:

Hassan A. Fracture tooth reattachment [Internet]. International Journal of Dental Research. 2018;6:35. Available:

Flanagan D. External and occlusal trauma to dental implants and a case report [Internet]. Vol. 19, Dental Traumatology. 2003;160–4. Available:

Alani A, Calvert G. Dental Trauma at a Glance. John Wiley & Sons. 2021;96.

Berman LH, Blanco L, de Blanco LP, Cohen S. A clinical guide to dental traumatology. Mosby; 2007;229.

Gupta R, Patel A, Nikhade PP, Chandak M, Ikhar A. Management of Ellis Class-IV Fractured Tooth With an Open Apex: A Case Report. Cureus. 2022;14(9):e29681.

Muzzammil M, Minhas MS, Ramzan Ali SAA, Jooma R, Minhas MO, Jabbar S. Primary trauma care course: Alternative basic trauma course in developing Countries. The Need of the Hour. Int J Clin Pract. 2021;e14327.

Slayton RL, Palmer EA. Traumatic Dental Injuries in Children: A Clinical Guide to Management and Prevention. Springer. 2019;178.

Aathira CM, Lakshmanan L. Association of ellis class 1 fracture in children of age 6-12 years. J Adv Pharm Technol Res. 2022; 13(Suppl 1):S31–5.

Lakshmi SBS, Lakshmanan L. Association of ellis class 2 fracture in 13-17 years old children. J Adv Pharm Technol Res. 2022; 13(Suppl 1):S26–30.