If a patient complains of pain upon provocation with heat or cold after an amalgam restoration, what is the likely issue?

• A. apical periodontitis
• B. deep amalgam restoration
• C. galvanic shock
• D. overcontoured restoration

Answer: (B)

The presence of pain upon provocation with heat or cold following an amalgam restoration is indicative of a deep amalgam restoration impacting the pulpal tissue. This type of restoration is often placed in cavities that extend closer to the pulp of the tooth. When thermal stimuli are applied, the nerve fibers within the pulp respond more vigorously due to reduced insulation and proximity to the restorative material.

In this context, the pulpal tissue may be hypersensitive after the procedure, particularly if the restoration has not adequately sealed the cavity or if it is in close proximity to the pulp, causing it to react to thermal changes. This scenario aligns well with the characteristics of a deep amalgam restoration, which may also be associated with issues such as inadequate anesthesia during the procedure, creating more pain during the placement or adjustment phases.

Understanding this relationship helps in diagnosing the issue correctly and managing the patient's pain effectively while considering adjustments or additional treatments that may be necessary for pain relief and restoration of the tooth.