[Pain after cementation of cast restorations]

Some patients experience pain after cementation of a cast restoration on a vital tooth. Limited data are available on the prevalence of this pain. In many cases the pain disappears within two weeks. The major cause of the pain might be attributed to more permeability of the dentine after preparation. Consequently, bacteria have free access towards the pulp. With respect to the cement, it is more likely that microleakage after cementation will be the cause of pulpal problems than toxicity of the cement. In order to prevent pain, the use of a desensitizer (a primer or a bonding) can be considered. However, use of a desensitizer in combination with some cements, can reduce the retention of a cast restoration. More important than the use of a desensitizer seem precautions during the procedures of preparing the restoration, like using sufficient cooling water and preventing a tooth from dehydration.