All- Ceramic Crown Preparation and the Remained wall Thickness of the Pulp Chamber

Abstract

Statement of Problem: A minimally invasive method of preparation is essential to prevent tooth structure weakening and pulp irritation; especially for mandibular anterior single-tooth all-ceramic crowns. According to many investigations, one of the most important reasons of pulp injury caused by tooth preparation for different restorative procedures is reduced “remained wall thickness” (RWT). In order to protect the pulp from irritation, it is necessary to maintain a 0.5 mm of RWT.Purpose: The purpose of the present study was to evaluate the effect of all-ceramic crown preparation on pulp chamber RWT of mandibular incisors.Materials and Method: Mesiodistal and buccolingual initial images of 24 extracted mandibular incisors were provided. The pulp chamber initial wall thicknesses of buccal, lingual and proximal surfaces of cervical, 1and 2 mm above the cervical areas and also the incisal surfaces of incisal sections were measured using digital radiography and Photoshop software. After all-ceramic crown preparation, images were provided at the same initial positions. The initial and remained pulp chamber wall thicknesses were statistically evaluated and analyzed by ANOVA, paired t-test and a post hoc Tukey test.Results: Repeated measures ANOVA showed that the mean of pre- or post-preparation wall thicknesses were not significantly different for each surface at the three horizontal levels (p> 0.05). However, there were significant differences between the surfaces for each section. Comparison of pre- and post-preparation wall thicknesses revealed significant differences (p< 0.05). Proximal surfaces of cervical sections had the least RWT (0.42±0.12).Conclusion: According to the results of the present study, the least amount of initial and remained wall thicknesses of pulp chamber were related to the proximal surfaces, particularly in cervical areas. Therefore a reduction of preparation to 0.7 mm is suggested to prevent future pulp injury for mandibular incisors of 35 to 40- year- old patients and younger who require all-ceramic crown preparations.