The critical time-lapse between various restoration placements and subsequent endodontic intervention

The purpose of this study was 2-fold: (1) to investigate the critical time-lapse of endodontic intervention subsequent to various restorations and tooth surfaces and (2) to assess and compare the risk factors associated with the restorations, tooth surfaces, and endodontic treatment.

A comprehensive computerized analysis of all dental school patients at the Case Western Reserve University School of Dental Medicine who received restorations from 2008-2013 was obtained. Inclusion and exclusion criteria were applied. The sample size was limited to teeth with endodontic treatment completed by the endodontic postgraduate dental clinic. Data collected included restoration type, restored tooth surfaces, tooth type, and the dates of restoration and subsequent endodontic treatment. A 2-sample paired t test (95% confidence interval, P < .05) and pair-wise comparison with Bonferroni corrections were implemented.

The mean time between restoration placement and resultant endodontic intervention was 270 days, with a mean difference of 247-294 days (P < .0001). Further analysis revealed composite resin was 1.91 times more likely than amalgam and 5.69 times more likely than crowns to cause resultant endodontic intervention. Teeth with 2 or more restorative surfaces required endodontic intervention (P < .001).

Of the patients who required endodontic treatment after restoration placement, the critical time-lapse was 9 months. Composite restorations and teeth with 2 or more restorative surfaces were significantly associated with endodontic treatment. From the results of the current study, we recommended that all dental practitioners should perform a thorough endodontic evaluation and diagnosis before, during, and after all restorative procedures.