In many discussions with dentists in the world, I found that there are different conceptions of the relationship between fixed restorations and endodontic treatment.

Some dentists say they like endodontic treatment on all fixed prosthetic teeth need to do, while others said that rarely need to do endodontic after fixed prosthetic mounted.

The truth is that there are some challenges when implementing fixed prosthetic without conducting nha.Sau treatment of many years of fixed restorations, perform thousand crowns and talk with hundreds of dentists, I made ​​some personal comments to help the dental practice to avoid failed endodontic treatment is after fixed prosthetic mounted. 
Reconstructing teeth can cause injury marrow

Tooth regeneration is performed when the remaining tooth structure to support fixed prostheses matter and while remaining a small dental tissue structure between surface preparation and the pulp chamber.

Dental tissue regeneration materials, and paste agent can stimulate marrow. Dental tissue regeneration materials today's most popular is composite but people still use amalgam. To reproduce material does not contribute to the consequences endodontic treatment, I suggest paste free system eroded before placing composite or use 4-methacryloxyethyl trimellitic anhydride or 4 META made ​​of paste amalgam as Amalgambond (Parkell, Farmingdade , NY) before placing amalgam.

Marrow stimulation of cement attached 
In recent years, cement attached irritating fluid is one of the most common causes leading to treatment marrow after fixed prosthetic mounted. However, associated with glass ionomer resin cement to increase strength as RelyX Luting Cement (3M, St. Paul, Minn.) And Fuji Plus (GC America, Alsip, III.) Has become the most common type of cement attached used in the United States.

This is the weak cement stimulation, significantly reduced the problem of sensitive teeth after mounting. I suggest to continue and expand the use of this cement.

Cutting Tools 
Some dentists use cutting tools with long time use. For me, using one-time drill and diamond nose for about 1 USD is appropriate. This avoids the unintended consequences of cutting when using expensive tools and reusable.

Water loss in the teeth 
The tooth preparation for fixed restorations took away most of the enamel to the dentin was exposed and tend to lose more water. To get good marks, the marking should be dry and this tends to dry teeth excessively. The protection of limited soft tissue and dried that has been proposed to avoid damaging the marrow due to the dehydration of the teeth.

Handpiece axis deviation 
Axis deviation of the hand drill is a common problem when the hand drill is used to grind many tooth structure. After many hot sterilized, high-speed drill was first reduced vibration and heart, causing a dam on the tooth and create potential injury marrow. Dentists are advised to observe the center of a recording device in hand drill. When detecting drill rotation is not concentric, repair or replace hand drill.

Pressure on the cutting tool

Hand-powered drill bit used for cutting should tap into that. However, in some cases, the change of sound that the cutting process is done with almost the maximum pressure. When using tools to capture sharp, just put a pressure just enough to easily cut teeth. If recording equipment is worn or the center of a hand drill down, leading to pressure to put a large on tool grinding teeth during work time. Cutting pressure causes heat and eccentric cutting tools, create a substantial impact on the teeth.

Occlusal problems com 
Fixed restorations bonded in the state of early touches the opposite will be the head and teeth sensitivity. I suggest should carefully evaluate all fixed restorations before attaching to determine the bite is too high or too low with paper thin bite as Accufilm 2 (Parkell) or Madaam Butterfly (Almore, Portland, Ore.) . The new doctors in training can make the mistake of accepting the associated prosthetic occlusal low because patients do not complain.

Recovery is acceptable the low occlusion in 1 or 2 days but eventually the teeth next to just attach the prosthesis will suffer due to increased pressure and risk of fractures under increased pressure .

Dead tooth pulp before starting the prosthesis 
Major tooth restoration tooth or bone marrow problems should be analyzed carefully before making fixed restorations. If there is doubt about the life of the fluid should endodontic treatment before restoration rather than fixed restorations and root canal treatment when needed. In my opinion, many crowns on the teeth dead pulp or tooth doubt that untreated marrow, wrong a few months or a few years that will have symptoms and endodontic treatment through the crown or prosthesis.

Prepared teeth too much 
Some doctors tend to wear many tissues when teeth fixed restorations. Although this makes the process dental work in labo easier but the danger to pulp. Grinding tooth as little as possible to the extent allowed to avoid damaging marrow. The reserve is especially necessary for young patients because the teeth have large pulp chamber.

Water and steam pressure to the teeth inappropriate 
Spray water too much triong when grinding teeth limited visibility, but water spray less heat will affect the marrow. In my experience, I suggest a simple clinical guidelines: if the gray humus layer deposited on the teeth while grinding, use more water / steam. Water and steam can be provided from a hand drill or hand spray side dental assistant for easy observation.

Conclusion 
When the clinicians found the fixed prosthetic teeth did need endodontic treatment more and more, which means that there are many factors contributing to death disadvantage marrow. Ten disadvantages I have mentioned in this article is based on my observations over the years as fixed restorations, research and discussion with other practitioners.