Avoiding pulpal death during fixed prosthodontic procedures

Avoiding pulpal death during fixed prosthodontic procedures", Gordon J. Cristensen, JADA, Vol. 133, November 2002: 1563 - 1564)

Early Endodontic Complications Following Fixed

Prosthodontic Restorations

Abeer S. Al-Khreisat BDS, MSc*

ABSTRACT

Objective: The aim of this study was to record the incidence of endodontic treatment that had to be done forvital abutment teeth during tooth preparation or immediately after the completion of the prosthetic treatment.

Methods: The study group consisted of all patients who received prosthodontic treatment at King Hussein Medical Center from December 2003 to May 2007. All the members of the study group received metalceramic restorations with at least one of the abutment teeth that had not received any form of root canaltreatment prior to the construction of the restoration. The abutment teeth were evaluated clinically andradiographically before preparation. The teeth were prepared using rotary cutting instruments with air and water spray coolant. Until the cementation of the final restorations, the prepared teeth were covered with temporary restorations. Any case of pulp exposure or pulpitis during preparation or immediately after ementation of the final restoration or within one week after cementation was recorded.

Results: A total of 264 patients (101 female and 163 male) received 290 fixed partial dentures during the

study period. The mean age of the patients was 40 years ranging from 18 to 73 years. For the 290 fixed partialdentures, there were 616 abutments and 415 pontics with an abutment/pontic ratio of 1.48: 1. Five hundred and seventy one of the abutment teeth (92.7%) were vital at the time of preparation and 45 teeth (7.3%) were endodontically treated. Thirty-four (6%) of the vital abutment teeth subsequently required endodontic treatment.

Conclusion: In this study 6% of the vital abutment teeth required endodontic treatment during or

immediately after cementation of the fixed partial dentures. The mandibular molars, maxillary molars and mandibular anteriors respectively (6.9%, 6.7%, 6.7%) were the most common teeth to develop symptoms of endodontic complications

Key words: Abutment teeth, Endodontic complications, Fixed partial dentures

JRMS June 2010; 17(2): 36-41

Introduction

A fundamental principle in replacing missing tooth

structure or missing teeth is the restoration of

function and esthetics at minimal biological cost.(1)

Given their reliability and durability, conventional

complete-crown coverage preparations generally are

the treatment of choice.(2) But despite the emphasis

on conservative preparation methods and restorative

procedures, undeniable threats to pulpal integrity

exist during the construction of fixed prosthetic

restorations.(3)

The literature demonstrated that each step in the

fabrication of a fixed prostheses is a source of

potential insult to the pulp.(4-6)Before being prepared

to receive fixed restorations some teeth are

subjected to pin placement, cement bases and

amalgam or composite restorative materials. Tooth

build up materials can be irritating to the pulp.(5)

*From the Department of Conservative Dentistry, King Hussein Medical Center, (KHMC), Amman-Jordan

Correspondence should be addressed to Dr. A. Al-Khreisat, P. O. Box 536 Amman 11953 Jordan,

E-mail:abeerkhreisat@yahoo.com

Manuscript received June 18, 2008. Accepted November 6, 2008