Clinical Evaluation of Secondary Endodontic Infection and Pulp Necrosis in Teeth Restored with Crown Restoration without Prior Root Canal Therapy

Abstract

Background: Vital pulp crown restorations can result in pulpal necrosis and secondary endodontic infection which can be clinically undetectable. Objective: The frequency of pulp necrosis and secondary endodontic infections in vital pulp crowned teeth without a previous endodontic procedure was assessed. Clinical and radiological conditions were also assessed. Methods: A cross-sectional study was carried out on 150 patients aged between 25-40 years, whose permanent teeth were crowned and placed without an endodontic procedure. Systematic random sampling was used to select the study participants. The collected data were analyzed by both descriptive and analytical statistics. Pulp testing was done by Endo-Ice®, Electric Pulp Tester, pain/tenderness to percussion, palpation tests and radiographs. Data such as type of crown, time of restoration, tooth concerned, symptoms, palpability of the pulp, and radiographic assessment of the periapical region were collected. Results: Evaluated crowned teeth also showed evidence of necrosis of the pulp and infection of the endodontic system clinically and radiologically. It was noted that pulp necrosis occurred in restoration time of more than 2 years and was evident in the presence of pain, tenderness to percussion and periapical radiographic findings. Conclusion: Teeth crowned without prior endodontic access demonstrated pulpal necrosis and endodontic infection clinically, and the crowned teeth were analyzed radiologically, The necrosis of the pulp was demonstrated by loss of sensitivity to pulp. The clinically evident pulpal necrosis and infection can be managed and diagnosed through routine postoperative assessments that include restoration time, clinical and radiological examinations and palpation tests.