Incidence of Accidental Pulp Exposure During Tooth Preparation by Undergraduate Students for Fixed Partial Dentures

To identify the incidence of accidental pulp exposure during the preparation of vital abutment tooth for porcelain- fused-to-metal (PFM) fixed prosthesis when prepared by undergraduate students.

A cohort study was conducted on 471 teeth, which were prepared to received PFM fixed partial denture, in patients between the age group of 20-40 years for 72 months. All the teeth were vital and healthy periodontally; preoperative radiographs were recorded. Measurements were taken from cone beam computed tomography (CBCT) scans of human extracted teeth for reference of the pulpal depths. Teeth with endodontic pulp exposure were documented and referred to the endodontic department.

In multivariate regression, when all variables were simultaneously considered and accounted for, tooth factors (arch and whether the tooth is anterior or posterior) and the distance between pulpal wall and cusp tip were significantly associated with odds of exposure (p = 0.006, 0.03 and < 0.0001). Maxillary and anterior were associated with higher odds of lateral exposure compared to mandibular and posterior teeth (OR = 10.34 and 3.53).

The present study draws the attention of the clinician towards the detrimental effect of tooth preparation on the vital pulp. The study concluded that maxillar and anterior teeth exposure has higher odds than mandibular and posterior teeth.

The undergraduate students must be trained to be extra careful while preparation of anterior and maxillary teeth for fixed partial dentures (FPD) to avoid pulpal exposure.