The document describes the World Health Organization's (WHO) classification system for traumatic injuries to primary and permanent anterior teeth in children. It outlines 12 classes of injuries ranging from enamel cracks or crazing (Class 0) to complete displacement of a tooth from its socket (Class 12). The classes are defined based on the structures involved (enamel, dentin, pulp) and type of displacement (intrusion, extrusion, lateral). The classification system provides a standardized way to categorize different levels of traumatic dental injuries.

1. 1
Traumatic Injuries toTraumatic Injuries to
anterior teeth ofanterior teeth of
childrenchildren
CLASSIFICATIONCLASSIFICATION

2. 2
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 0Class 0
An incomplete fractureAn incomplete fracture
of the enamel withoutof the enamel without
loss of tooth substanceloss of tooth substance
Enamel crackEnamel crack
Enamel crazingEnamel crazing

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Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 1Class 1
A fracture of the enamelA fracture of the enamel
with loss of toothwith loss of tooth
substance not involvingsubstance not involving
the pulpthe pulp
( Enamel fracture )( Enamel fracture )

4. 4
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 2Class 2
Fracture of enamel &Fracture of enamel &
dentine not involvingdentine not involving
the pulp.the pulp.

5. 5
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 3Class 3
Fracture of enamel &Fracture of enamel &
dentine exposing thedentine exposing the
pulp.pulp.

6. 6
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)

7. 7
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 4Class 4
A fracture involving enamel,A fracture involving enamel,
dentine & cementum withoutdentine & cementum without
pulp exposure.pulp exposure.

8. 8
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 5Class 5
A fracture involving enamel,A fracture involving enamel,
dentine and cementum withdentine and cementum with
pulp exposure.pulp exposure.

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Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 6Class 6
Root fractureRoot fracture
A fracture involvingA fracture involving
cementum, dentine & pulp.cementum, dentine & pulp.

10. 10
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)

11. 11
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)

12. 12
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 7 ConcussionClass 7 Concussion
An injury to the toothAn injury to the tooth
without abnormal looseningwithout abnormal loosening
or displacement but withor displacement but with
marked reaction to percussion.marked reaction to percussion.
There may be change of colorThere may be change of color
of the tooth and/ or fistulousof the tooth and/ or fistulous
tract.tract.

13. 13
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 8 (Loosening)Class 8 (Loosening)
Luxation – An injury to theLuxation – An injury to the
tooth with abnormal looseningtooth with abnormal loosening
but without displacementbut without displacement
The difference fromThe difference from
concussion is the degree ofconcussion is the degree of
mobility.mobility.

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Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 9Class 9
Lateral displacementLateral displacement
A displacement of theA displacement of the
tooth in a directiontooth in a direction
other than axially.other than axially.

15. 15
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)

16. 16
Class 10Class 10
IntrusionIntrusion
A displacement of the toothA displacement of the tooth
into the alveolar boneinto the alveolar bone
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)

17. 17
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 11Class 11
ExtrusionExtrusion
A partial displacement ofA partial displacement of
the tooth out of its socketthe tooth out of its socket

18. 18
Classification of Traumatic Injuries to primary &Classification of Traumatic Injuries to primary &
permanent teeth (WHO classification)permanent teeth (WHO classification)
Class 12Class 12
AvulsionAvulsion
A complete displacementA complete displacement
of the tooth out of itsof the tooth out of its
alveolar socketalveolar socket

19. 19
Classification of Traumatic InjuriesClassification of Traumatic Injuries
1. Enamel crazing1. Enamel crazing
Crown fracture involving enamelCrown fracture involving enamel
2. Crown fracture involving enamel & dentine2. Crown fracture involving enamel & dentine
3. Crown fracture involving enamel, dentine & pulp.3. Crown fracture involving enamel, dentine & pulp.
4. Crown fracture involving enamel + loss of crown4. Crown fracture involving enamel + loss of crown
5. Root fracture5. Root fracture
6. Displacement injury6. Displacement injury

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Classification (Based on Ellis + Davey 1970)Classification (Based on Ellis + Davey 1970)
Class IClass I
A crown # involving enamel only.A crown # involving enamel only.
This may result in enamel loss (or) a craze line or crackThis may result in enamel loss (or) a craze line or crack
Class IIClass II
A crown # involving enamel + dentine but not the dental pulp.A crown # involving enamel + dentine but not the dental pulp.
Class IIIClass III
A crown # involving E, D + pulpA crown # involving E, D + pulp
(But with considerable tooth structure remaining)(But with considerable tooth structure remaining)

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Class IVClass IV
A crown # involving E, D + pulp where the crown ofA crown # involving E, D + pulp where the crown of
the tooth was lost.the tooth was lost.
Class VClass V
A root # involving cementum, dentine + pulp.A root # involving cementum, dentine + pulp.
The # may be- horizontal, vertical or diagonal.The # may be- horizontal, vertical or diagonal.
Class VIClass VI
Displacement of the tooth, either partial or totalDisplacement of the tooth, either partial or total
from the bony socket.from the bony socket.
Classification (Based on Ellis + Davey 1970)Classification (Based on Ellis + Davey 1970)

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