What is the primary reason for post-crown cementation sensitivity?

Post-crown cementation sensitivity is primarily attributed to microleakage. When a crown is placed on a tooth, it should create a tight seal to prevent bacteria and fluids from seeping underneath it. If the seal is compromised due to poor fit or inadequate bonding, microleakage can occur. This allows oral fluids and bacteria to contact the underlying tooth structure, potentially leading to sensitivity, irritation of the pulp, or even recurrent decay.

Microleakage can result from various factors, including discrepancies in the crown's margins or the quality of the adhesive used. Consequently, when patients experience sensitivity following crown placement, it often signifies that the integrity of the seal is inadequate, allowing stimuli to affect the nerve endings in the tooth more readily.

While considerations about the amount of cement used or the patient's response to the material are important, they are not the primary contributors to the sensitivity observed after crown cementation. An inadequate cement application can lead to poor retention, and while too much cement can also create problems, neither directly addresses the underlying issue of microleakage as a path to post-cementation sensitivity.