The Influence of Full Coverage Restorations On Pulp Vitality: A Ten-Year Retrospective Study

INTRODUCTION: The incidence of pulpal disease after delivery of a full-coverage crown has been previously described as between 2-19%. The objective of this study was to identify and analyze the factors that contribute to the incidence of NS-RCT after the delivery of single-unit full-coverage restorations. MATERIALS AND METHODS: Insurance claims from 88,409 crown placements in the Delta Dental of Wisconsin Insurance database were analyzed from the years 2008 to 2017. The Cox Regression model was used to analyze the effect of the predictor variables on the survival of the tooth. Untoward events were defined as NS-RCT, tooth extraction, retreatment of root canal, or apicoectomy as defined by the Code on Dental Procedures and Nomenclature. RESULTS: Out of 88,409 crowns placed, 8.86% were all-metal, 41.40% were all-porcelain and 49.64% were porcelain fused to metal (PFM). The majority of all untoward events for all groups consisted of non-surgical root canal therapy. The probability of survival of all teeth with crowns placed was 90.41% after 9 years. PFM crowns exhibited a higher rate of untoward events than all-metal crowns, and lower rate than all-ceramic crowns. Crowns placed on individuals between 50 years of age and younger had higher rates of untoward events than those placed on individuals ages 51 years and above. CONCLUSION: The risk of endodontic treatment after the placement of crowns is low. This risk increases with the placement of all-porcelain or metal-and-porcelain crowns and as age decreases