Abstract
Introduction
This study aimed to evaluate the risk factors and occurrence of pulpal disease in
patients who received either full-coverage (crowns) or large noncrown restorations
(fillings, inlays, or onlays involving ≥3 surfaces).
Methods
A retrospective chart review identified 2177 cases of large restorations placed on
vital teeth. Based on the restoration type, patients were stratified into various
groups for statistical analysis. After restoration placement, those who required endodontic
intervention or extraction were classified as having pulpal disease.
Results
Over the course of the study, 8.77% (n = 191) of patients developed pulpal disease. Pulpal disease was slightly more common
in the large noncrown group than the full-coverage group (9.05% vs 7.54%, respectively).
For patients who received large fillings, there was not a statistically significant
difference based on operative material (amalgam vs composite: odds ratio = 1.32 [95%
confidence interval, 0.94–1.85], P > .05) or the number of surfaces involved (3 vs 4: odds ratio = 0.78 [95% confidence
interval, 0.54–1.12], P > .05). The association between the restoration type and the pulpal disease treatment
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 with 5.68% (n = 101) in the large noncrown group.
Conclusions
It appears that ∼9% of patients who receive large restorations will go on to develop
pulpal disease. The risk of pulpal disease tended to be highest in older patients
who receive large (4 surface) amalgam restorations. However, teeth with full-coverage
restorations were less likely to be extracted.
Key Words
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Article info
Publication history
Published online: March 08, 2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 American Association of Endodontists.
