Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis

Zvi Gutmacher1, Eli Peled2, 3, Doron Norman2, 3, Shaul Lin3, 4, *
1 Department of Maxillofacial Rehabilitation, Rambam Health Care Campus, Haifa, Israel
2 Department of Orthopedic Surgery B, Rambam Health Care Campus, Haifa, Israel
3 The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
4 Endodontic and Dental Trauma Department, Rambam Health Care Campus, Haifa, Israel

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Creative Commons License
© Gutmacher et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Endodontic and Dental Trauma Department, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel; Tel: 972-4-8541927; Fax: 972-4-8370752; E-mail:



Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other tooth trauma is detected. Any suggestion of alveolar fractures should be further investigated with an appropriate radiograph.


This case report shows a pathognomonic sign that detects and diagnosis single tooth alveolar bone fractures, i.e., a localized hematoma crossing the attached gingiva from the free gingival margin to the vestibular mucosa. This should serve as a warning for localized alveolar bone fracture.

A visualized hematoma and gentle, careful palpation may help detect covered fractures when the overlying mucosa is not perforated.

Keywords: Alveolar bone fracture, Avulsion, Dental trauma, Luxation.