HOME - Clinical cases - Prosthodontics
 
 
12 December 2023

Prosthetic preparation and cementation: how does the pulp react?

Simona Chirico


A comprehensive pulpal health assessment should be completed prior to the placement of new restorations, as several studies have shown that vital teeth have a 9% chance of becoming necrotic after preparation to accommodate a crown and between 5% and 16% of incurring a pulp pathology within 10 years of its cementation. This is mainly caused by the different temperature degrees that can be reached without adequate refrigeration during the preparation phase (it can increase by approximately 10° C) and during the cementation temperatures can reach up to approximately 52°C.

Materials and methods

In a study published in the Journal of Endodontics, the authors evaluated the risk factors and onset of pulp disease in patients who received a crown compared to those who received direct fillings or inlays as restorations. The authors conducted a retrospective analysis of the clinical records of 2177 cases of large restorations performed on vital teeth. Based on the type of restoration, patients were classified into various groups for statistical analysis.

After restoration placement, cases requiring endodontic intervention or extraction were classified as “having pulp disease.”

Results

8.77% (n = 191) of patients developed pulp disease. Pulp disease was slightly more common in the extensive reconstruction but no crown group than in the full coverage group (9.05% vs 7.54%, respectively). For patients who received large fillings, there was no statistically significant difference between the filling materials used (amalgam vs composite: odds ratio 51.32 [95% confidence interval, 0.94-1.85], P >.05) or based on the number of surfaces affected (3 vs 4: odds ratio 0.78 [95% confidence interval, 0.54-1.12], P >.0.05). The association between the type of restoration and the treatment of pulp disease performed was statistically significant (P < .001). The full coverage group more frequently underwent endodontic treatment than extraction (5.78% vs 3.37%, respectively). Only 1.76% (n = 7) of teeth in the full coverage group were extracted compared to 5.68% (n = 101) in the no-crown group (extractions likely due to fractures).

Conclusions

9% of patients who receive large restorations will develop pulp disease. The risk of pulp disease tends to be higher in older patients who receive large (4-surface) amalgam restorations.


Related articles

The aim of this study was to identify a correct clinical, surgical, and prosthetic management of endosseous implants replacing missing teeth in the anterior maxilla, achieving predictable aesthetic...


Mucormycosis has been prevalent in the past few years with the COVID-19 pandemic largely affecting the maxilla due to its proximity to the respiratory corridor. 


The “United States Dental Prosthetics Market Size, Share & Trends Analysis, 2024-2030 | MedSuite | Includes: Crowns & Bridges, Inlays & Onlays, and 4 more” report has been added to...


Medit Innovation Day 2023 is a free online event open to all dentists around the world. With the upcoming launch of the Medit ClinicCAD app, the company will offer a seamless dental CAD software that...


Two-piece implants have emerged that can minimize these problems, providing prosthetic versatility, with the possibility of angling the abutment, as well as better positioning of the implant.


Read more

The ‘hygiene hypothesis’ suggests that a reduction in the microbial exposure due to improved health measures has contributed to an immunological imbalance in the intestine and increased the...


Lay Soon and Elissa Elmorr each took first place in the Graduate Trainee and Dental Predoctoral Oral Presentation competitions respectively at the 2025 School of Dentistry Research Day on Wednesday.


vVARDIS, a Swiss high-growth dental company, and OrbiMed, a leading healthcare investment firm, recently announced the closing of a $35 million financing.


Greenland Advanced Oral Care is proud to announce the addition of Dr. Eryn Huber to its expert dental team. 


Torch Dental, a pioneering technology platform specializing in dental supply management, ordering, and budgeting, is thrilled to partner with the Sacramento District Dental Society (SDDS), an...


 
 
 
 

 
 
 
 

Most popular

 
 

Events