Dental OSCE (Objective Structured Clinical Examination) Practice Exam

What should be suspected when significant leakage occurs below a crown?

1. Internal resorption

2. Pulp necrosis

3. Core material failure

4. Periapical pathology

The correct answer is: Pulp necrosis

When significant leakage occurs below a crown, pulp necrosis is a primary consideration because this condition indicates that the dental pulp has died or is dying, which can lead to the loss of pulp vitality. When a crown is placed, it is designed to seal the underlying tooth structure and protect the pulp from external stimuli, such as bacteria and decay. If there is leakage, it suggests that this seal is compromised, allowing pathogens to invade and potentially cause inflammation and infection within the pulp chamber. Pulp necrosis can arise from caries, trauma, or previous dental treatments that might have damaged the tooth or compromised the integrity of the pulp. As bacteria infiltrate through compromised margins or gaps, they can cause an inflammatory response that ultimately leads to necrosis. This situation might not only present clinical symptoms, such as pain or sensitivity, but can also lead to further complications such as periapical abscesses if the infection spreads beyond the apex of the root. Understanding the implications of crown leakage is crucial in dental practice, as timely intervention can prevent more severe consequences, making the suspicion of pulp necrosis paramount in such scenarios. Thus, when significant leakage is noted, assessing the vitality of the pulp and considering pulp necrosis as a possible complication is essential for effective