Factors Associated with the Need for a Primary Endodontic Treatment after Single-Unit Crown Cementation: A...

This case-control study aimed to identify factors associated with an increased risk for endodontic treatment after single-unit crown cementation and to describe the timeline of such events.

After evaluating the electronic records of all single-unit crowns placed on nonendodontically treated teeth between 1999 and 2019 and excluding teeth with preexisting questionable or confirmed endodontic disease, "cases" were identified as teeth requiring primary endodontic treatment after crown cementation. This was not examined in the current study because the cases and controls were matched by tooth type.

Overall, 69 teeth without any suspected or confirmed past endodontic disease required an endodontic intervention after crown cementation. The mean number ± standard deviation of restorations in a tooth before crown cementation was significantly higher among the cases than the matched controls (2.16 ± 0.99 vs 0.78 ± 0.78, P < .05). Teeth with ≥2 and ≥3 previous restorations had an almost 4 (odds ratio = 3.81; 95% confidence interval, 1.56-9.29; P < .05) and almost 6 (odds ratio = 5.97; 95% confidence interval, 1.230-28.95; P < .05) times higher risk, respectively, for endodontic treatment after crown cementation compared with teeth with ≤1 restoration present before crown cementation. The majority (65%, n = 45) of teeth in the cases group required endodontic treatment during the first 3 years after crown cementation.

The presence of multiple restorations at the time of crown cementation was identified as a significant predictive factor for the need for endodontic treatment after crown cementation in teeth with no preexisting questionable or confirmed endodontic disease. Therefore, clinicians should be aware and inform patients about the increased risk of primary endodontic treatment in teeth with a history of more than 1 restoration, especially during the first 3 years after permanent crown cementation.