Pulp Disease May Follow Restorative Dental Treatment

Phillip Bonner, DDS

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A study published in the International Endodontic Journal assessed whether the timing of pulp disease after tooth restoration was associated with the type of restorative dental material used, extent of the restoration, or tooth type.

A comprehensive search and analysis of data using the Titanium Oral Health Management software program at the Oral Health Centre of Western Australia were performed to correlate procedural codes for teeth that had restorations placed and subsequently developed pulp disease requiring endodontic treatment or extraction from January 1, 2009, to December 31, 2013.

Manual analysis of paper and/or electronic patient record cards was also performed. Data collected included restoration type, restored tooth surfaces, tooth type, and the dates of restoration and subsequent endodontic intervention or extraction.

Of 330 teeth that met the inclusion criteria, 84 (26%) had composite resin restorations, 80 (24%) had amalgams, 119 (36%) had glass-ionomer cement (GICs), and 47 (14%) had crowns. The average time between restoration and further intervention was 330 days with a range from 3 to 1,775 days (approximately 5 years).

Teeth restored with crowns or 5‐surface restorations were significantly more likely to require earlier intervention than other restorations. Premolar and anterior teeth were also more likely to require earlier intervention.

The study concluded that teeth that developed pulp disease requiring further intervention that were restored with crowns and 5‐surface GIC developed the disease sooner than teeth that were restored with amalgam or composite. In teeth with 5-surface restorations that developed pulp disease requiring further intervention, premolar and anterior teeth developed the pulp disease sooner than molars. (Source: International Endodontic Journal, May 19, 2018)

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