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The Incidence of Root Canal Therapy after Full-Coverage Restorations: A 10-Year Retrospective Study. J Endod 2020 May;46(5):605-610



Pubmed ID




Scopus ID

2-s2.0-85082812841   1 Citation


INTRODUCTION: The process of restoring a tooth with a crown leaves many opportunities for pulpal irritation. The objective of this study was to identify and analyze the factors that contribute to the incidence of nonsurgical root canal therapy (NS-RCT) after the delivery of single-unit full-coverage restorations.

METHODS: Insurance claims from 88,409 crown placements in the Delta Dental of Wisconsin insurance database were analyzed from the years 2008-2017. 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: Of 88,409 crowns placed, 8.97% were complete metal, 41.40% were all ceramic, and 49.64% were porcelain fused to metal (PFM). The probability of survival of all teeth with crowns placed was 90.41% after 9 years. NS-RCT was the most common untoward event. PFM crowns exhibited a higher rate of untoward events than complete metal crowns and a lower rate than all-ceramic crowns. Crowns placed on individuals 50 years of age and younger had higher rates of untoward events than those placed on individuals ages 51 years and older.

CONCLUSIONS: The risk of endodontic treatment after the placement of crowns is low. This risk increases with the placement of all-ceramic or PFM crowns and as the age of the patient decreases.

Author List

Yavorek A, Bhagavatula P, Patel K, Szabo A, Ibrahim M


Pradeep Bhagavatula BDS, MPH, MS Assistant Professor in the Department of Dental Clinical Services department at Marquette University
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Dental Porcelain
Dental Restoration Failure
Middle Aged
Retrospective Studies
Root Canal Therapy
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a