OR16 - Factors Affecting the Time Lapse between Restorations and Pulp Disease: A Retrospective Cohort Study

Wednesday, April 2, 2025

12:45 PM – 1:00 PM EST

Location: Hynes Convention Center, Floor 3, Room 310

Presenter(s)

Shivani Desai, D.D.S.

Endodontics Resident
University of Toronto
Toronto, Ontario, Canada

Disclosure information not submitted.

Co-Author(s)

AT

Adam L. Tepperman, D.D.S., M.Sc.

Endodontics Resident
University of Toronto
Toronto, Ontario, Canada

Disclosure information not submitted.
Ahmed Ben Suleiman, B.D.S., M.Sc.

Resident
University of British Columbia
Vancouver, British Columbia, Canada

Disclosure information not submitted.
Gevik Malkhassian, D.D.S., M.Sc.

Associate Professor
University of Toronto
Toronto, Ontario, Canada

Disclosure(s): No financial relationships to disclose
David Chvartszaid, D.D.S., M.Sc.

Assistant professor, Prosthodontics and Periodontics
University of Toronto
Toronto, Ontario, Canada

Disclosure information not submitted.
Jim Yuan Lai, D.M.D.

Vice-Dean, Education
University of Toronto
Toronto, Ontario, Canada

Disclosure information not submitted.
Amir Azarpazhooh, D.D.S., Ph.D., M.Sc. (he/him/his)

Professor
University of Toronto
Toronto, Ontario, Canada

Disclosure(s): No financial relationships to disclose

Disclosure(s):

Gevik Malkhassian, D.D.S., M.Sc.: No financial relationships to disclose

Amir Azarpazhooh, D.D.S., Ph.D., M.Sc.: No financial relationships to disclose

Objective(s): This retrospective study aimed to assess the risk factors and critical time elapsed from restoration to pulpal deterioration.

Methods: A computerized search of the University of Toronto Faculty of Dentistry's electronic patient records (1999-2023) was performed to identify permanent teeth with a history of restoration(s) subsequent endodontic treatment. The mean time lapse between the terminal restoration and endodontic intervention was calculated and the effect of predictor variables was analyzed using Cox regression.

Results: 1,363 teeth met the inclusion criteria. The average time elapsed from any terminal restoration to subsequent endodontic treatment was 30.5 months (range: 0.5-266.8 months). It was the longest for crown (46.1 months, n=178), followed by amalgam (32.2 months, n=383), composite resin (26.6 months, n=714), and shortest for glass ionomer restorations (23.5 months, n=88). Terminal restorations with three or more surfaces (24.4 months, n=335), history of three or more prior restorations (24.9 months, n= 63), and history of pulp exposure (20.3 months, n=141) resulted in earlier development of pulp disease. The results for the predictor variables and comparison to matched controls are underway.

Conclusions: Restored teeth developed pulpal disease after a mean time lapse of 30.5 months. Crown and amalgam restorations resulted in slower development of pulp disease while multi-surface restorations, multiple restorative interventions, and history of pulp exposure expedited pulpal deterioration.