Effect of Intracapsular Pressure on Pulp Sensitivity in Teeth Affected by Jaw Cysts: A Clinical Study Combined With Finite Element Analysis

AIM: The objective of this research was to explore the relationship between intracapsular pressure (ICP) and pulp sensitivity in teeth affected by jaw cysts and to examine clinical and radiographic factors associated with variations in ICP. METHODS: This retrospective study included 60 patients with jaw cysts confirmed by radiographic and histopathological examinations. Radiographic data, ICP and pulp sensitivity were collected and analysed for correlation. In addition, finite element analysis (FEA) was applied to simulate the biomechanical effects of ICP on the apical neurovascular bundle. Linear correlation analysis, independent-samples t test and variance analysis were used for statistical analysis. RESULTS: Elevated ICP was significantly associated with reduced pulp sensitivity, particularly in teeth with root apices positioned 0 to 1 mm from the cystic cavity (P = .001, r = 0.30). The relat ionship between ICP and cyst volume proved site-specific: negative in the mandible (P = .016, r = -0.13), positive in the anterior maxilla (P = .002, r = 0.54) and nonsignificant in the posterior maxilla (P = .654, r = 0.17). FEA modelling confirmed that high ICP induces mechanical deformation of the apical neurovascular bundle, providing a biomechanical mechanism for reduced pulp sensitivity. CONCLUSIONS: Increased ICP was associated with reduced pulp sensitivity in teeth affected by jaw cysts. Preoperative radiographic evaluation may help estimate ICP and guide decisions for pulp-preserving treatment strategies.