Perception of Prophylactic Root Canal Therapy for Teeth used as Abutments in Fixed Partial Dentures among Dental Surgeons in Maharashtra and Kerala: A Questionnairebased Cross-sectional Survey

Abstract

Introduction: The pulps of healthy teeth used as abutments for Fixed Partial Dentures (FPD) undergo mechanical and thermal stresses during tooth preparation. The remaining dentin thickness, the heat produced during tooth preparation, and the permeability of dentinal tubules influence the severity of pulpal injury. Prophylactic Root Canal Therapy (RCT) could be an option to provide better outcomes for FPD treatment. Aim: To assess dentists’ perception regarding the need for prophylactic RCT of abutment teeth in FPD through a questionnaire. Materials and Methods: A Questionnaire based Cross-sectional Surve was conducted among 200 dental professionals in the Indian states of Kerala and Maharashtra over a period of two months. The participants included dental professionals from private clinics, dental Institutions, and postgraduate students in these states. The Chi-square test of proportion was performed to assess significant differences between each response. Results: Total 67 out of 200 practitioners, accounting for 33.5%, recommended prophylactic RCT, while 60 (30%) practitioners disagreed with it. A total of 152 (76%) practitioners suggested clinical assessment of abutment teeth before starting the tooth preparation. Total 70 (35%) practitioners had never experienced pulpal damage in abutment teeth in their clinical practice. In contrast, 127 (63.5%) practitioners experienced pulpal damage in less than half of the total cases, and 3 (1.5%) practitioners experienced failures like pulp necrosis or irreversible pulpitis in more than half of the total cases. Conclusion: Total 33.5% of the surveyed dental practitioners recommended prophylactic endodontic treatment for abutment teeth in FPDs. Implementing precise elective RCT guidelines into dental curricula was suggested as a potential avenue to enhance decision-making and improve patient outcomes by reducing the incidence of pulpal damage beneath FPDs.

Keywords

• dentin bonding agents
• symptomatic irreversible pulpitis
• treatment protocol
• vital tooth preparation