title: Periapical status of non-root-filled teeth with resin composite, amalgam, or full crown restorations: a cross-sectional study of a Swedish adult population.
abstract: BACKGROUND
  Experimental studies show that dental pulp cells respond unfavorably to contact with resin composite restorative material. Hypothetically, in a random population, the frequency of apical periodontitis should be higher for teeth restored with resin composite than with amalgam. Therefore, the aim was to compare the periapical status of non-root-filled teeth restored with resin composite, amalgam, or laboratory-fabricated crowns in an adult Swedish population.
  
  
  METHODS
  The subjects comprised 440 individuals from a randomly selected sample of 1,000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all non-root-filled teeth by clinical examination and intraoral clinical photographs. Periapical status was evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed using the chi-square test and logistic regression analysis.
  
  
  RESULTS
  There was no significant difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite or amalgam (1.3% and 1.1%, respectively). The frequency of AP for teeth restored with laboratory-fabricated crowns was significantly higher (6.3%). Regression analysis showed no association between AP and resin composite restorations but a significant association with laboratory-fabricated crowns.
  
  
  CONCLUSIONS
  The results indicate that the risk of damage to the pulp-dentin complex from exposure to resin composite material and dentin bonding agents shown in experimental studies is not reflected in the clinical setting. However, in the study sample, AP was diagnosed in a significantly higher proportion of teeth restored with laboratory-fabricated crowns.
authors.affiliation: Department of Endodontics, Malmö University, Malmö, Sweden.
authors.forename: Victoria
authors.initials: V
authors.lastname: Dawson
authors.affiliation: Department of Endodontics, Malmö University, Malmö, Sweden. Electronic address: kerstin.petersson@mah.se.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Petersson
authors.affiliation: Department of Endodontics, Malmö University, Malmö, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Wolf
authors.affiliation: Department of Oral Diagnostics, Malmö University, Malmö, Sweden.
authors.forename: Sigvard
authors.initials: S
authors.lastname: Akerman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000453:epidemiology; D003188:Composite Resins / Q000737:chemistry*; D003430:Cross-Sectional Studies; D003442:Crowns / Q000706:statistics & numerical data*; D003723:Dental Amalgam / Q000737:chemistry*; D003731:Dental Caries / Q000453:epidemiology; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000453:epidemiology*; D010781:Photography; D016300:Radiography, Bitewing; D011862:Radiography, Panoramic; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003188:Composite Resins; D003723:Dental Amalgam
keywords: Apical periodontitis; cross-sectional study; crowns; dental amalgam; dental pulp; epidemiology; periapical status; resin composite