An analysis of the timing and materials associated with pulp disease following restorative dental treatment

To assess whether the timing of pulp disease after tooth restoration was associated with type of restorative dental material used, extent of the restoration or tooth type.

A comprehensive search and analysis of data using the Titanium Oral Health Management software program at The Oral Health Centre of Western Australia were performed to correlate procedural codes for teeth that had restorations placed and subsequently developed pulp disease requiring endodontic treatment or extraction from 1st January 2009 to 31st December 2013. Manual analysis of paper and/or electronic patient record cards was also performed. Data collected included restoration type, restored tooth surfaces, tooth type and the dates of restoration and subsequent endodontic intervention or extraction.

Of 330 teeth that met the inclusion criteria, 84 (26%) had composite resin restorations, 80 (24%) had amalgams, 119 (36%) had glass-ionomer cement (GICs), and 47 (14%) had crowns. The average time between restoration and further intervention was 330 days with a range from 3 to 1775 days (approximately 5 years). Teeth restored with crowns or five-surface restorations were significantly more likely to require earlier intervention than other restorations. Premolar and anterior teeth were also more likely to require earlier intervention.

Teeth that developed pulp disease requiring further intervention that were restored with crowns and five-surface GIC developed the disease sooner than teeth that were restored with amalgam or composite. In teeth with five-surface restorations that developed pulp disease requiring further intervention, premolar and anterior teeth developed the pulp disease sooner than molars.