Remaining Dentine Thickness Following Tooth Preparation And its Impact on Dentine – Pulp Complex

There are many factors accused of causing pulpal damage, but studies indicate that endodontic complications after placement of fixed prosthetic crowns and bridges are entirely iatrogenic and as a consequence of a deep tooth preparation. In 2mm of the remaining dentine thickness after preparation, there are significant reductions in cellular cell adhesion molecules in the pulp of the prepared tooth data compared to those intact. Researchers confirm that even this decline may be an expression of early stages of pulp inflammation. According to Murray & co, the number of odontoblasts in a dentine thickness of 2.5-0.5mm, was reduced by 13.6%; in a dentine thickness of 0.5-0.01mm, this number was reduced by 33.7%, and in pulp exposure the number of odontoblasts was reduced by 99%. Also, I. Abouta and his associates concluded that the number of odontoblasts and dentine repair activity was mostly affected by tooth preparation (cavity preparation/tooth preparation for crowns) variables rather than the type of filling, material, or patient related factors (age, gender). To inform the dentists’ community with the latest studies and recommendations which raises awareness of the effect that the remaining dentine thickness after tooth preparation, has on the pulp vitality. Studies suggest that clinicists should aim for conservative tooth preparation in order to preserve the vitality of the pulp. The number of odontoblasts and the amount of reparative dentine is disproportional to the amount of dentine removed during the tooth preparation. The remaining dentine thickness in the cavity/tooth has a huge impact on the pulp vitality, and during restoration procedures a dentine thickness of 0.5mm or more than necessary to avoid an irreversible damage of the pulp.