In this article, we explain briefly the main causes of Pain that is associated after placment of an Amalgam Dental Restoration, its Clinical picture and its treatment.
Post-restoration Hypersensitivity
Post-restoration HypersensitivityIt may result due to irritation during cavity preparation (Trauma, pressure, vibration, heat generation and desiccation) &/or irritation from the restoration.
Etiology
Hypersensitivity in a recently amalgam restored tooth may be generated by stimulation of freshly exposed permeable virgin dentin surface by:
- Galvanic Stimuli generated on immediate contact with opposing dissimilar metals.
- Thermal: Thermal stresses conducted through large no isolated metallic restorations.
- Chemical and osmotic: Stimuli by osmotic fluids that penetrate through leakage, hairy crack or fracture in the tooth or restoration.
- Tactile: Pressure of premature contact.
Clinical picture
- Severe pain occurring after insertion of a restoration mostly indicates pulp involvement following microscopic exposure.
- If pain occurs on thermal stimulation and continues long after removal of stimulus, it suggests pulp pathology as pulpitis.
- Pain on cold application indicates reversible pulpitis.
- If it results from biting, it suggests periodontal involvement, premature contact or fractured restoration.
- Dull aching pain several days after insertion of restoration may be due to delayed expansion of amalgam after moisture contamination of zinc containing amalgam.
Treatment
- Prevention by dentin sealing with cavity varnishes, liners or bases.
- Elimination of occlusal interference and pre-mature contacts.
- Pulp involvement by exposure or advanced pulpitis is treated with root canal treatment.
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