Root Canal Treatment After Fixed Prosthodontic Restorations: A Retrospective Observational Study

Background/Objectives: Root canal treatment (RCT) may be required after full-coverage crown placement in initially vital teeth due to biological and restorative factors affecting pulp vitality. However, the timing and distribution of clinical variables associated with teeth requiring RCT after crown placement remain insufficiently described. The aim of this study was to evaluate this timing and distribution using retrospective data collected between 2011 and 2024. Methods: This study included 588 vital teeth treated with metal-ceramic or zirconia crowns between 2011 and 2024. Recorded variables were age, gender, tooth type and location, crown material, bruxism, number of abutment teeth, and time to RCT. Statistical analyses were performed using SPSS v25.0, and as data were not normally distributed (Shapiro-Wilk test), Mann-Whitney U, Kruskal-Wallis, and chi-square or Fisher's exact tests were used (p < 0.05). Results: Of the 588 teeth, 36.1% were from male and 63.9% from female patients, and most crowns were metal-ceramic (80.8%), followed by zirconia (19.2%). Significant associations were observed between tooth group and jaw location (p < 0.001), number of abutment teeth (p < 0.001), and crown material type (p < 0.001). RCT was most frequently recorded during the fifth year after crown placement (52.6% of cases), with a mean time of 4.13 ± 1.79 years. Tooth extraction was observed in 5.3% of teeth. Conclusions: This study provides descriptive information regarding the distribution and timing of RCT in initially vital teeth following fixed prosthodontic restorations. The findings should be interpreted as a characterization of affected cases rather than as evidence of risk factors or predictors of RCT occurrence.