The Pulpal Response to Crown Preparation and Cementation.

Area of Science:

• Dental Restorations
• Pulpal Disease Etiology
• Restorative Dentistry

Background:

• Evaluating risk factors for pulpal disease is crucial for patient outcomes.
• Large dental restorations, including full-coverage crowns and extensive non-crown fillings, inlays, or onlays, are common procedures.
• Understanding the sequelae of these restorations is essential for clinical decision-making.

Purpose of the Study:

• To assess the occurrence of pulpal disease following large restorations.
• To identify risk factors associated with pulpal disease after receiving full-coverage or large non-crown restorations.
• To compare the need for endodontic intervention versus extraction based on restoration type.

Main Methods:

• A retrospective chart review of 2177 cases involving large restorations on vital teeth.
• Patients were stratified based on restoration type (full-coverage vs. large non-crown).
• Pulpal disease was defined as requiring endodontic intervention or extraction post-restoration.

Main Results:

• Overall, 8.77% of patients developed pulpal disease.
• Pulpal disease was slightly more prevalent in the large non-crown group (9.05%) than the full-coverage group (7.54%).
• Teeth with full-coverage restorations were significantly less likely to be extracted (1.76%) compared to large non-crown restorations (5.68%).

Conclusions:

• Approximately 9% of patients undergoing large restorative procedures may develop pulpal disease.
• Older patients receiving large, four-surface amalgam restorations showed a tendency towards higher pulpal disease risk.
• Full-coverage restorations demonstrated a lower extraction rate, suggesting better long-term tooth preservation.