In cast alloy restorations, the pulp is affected by which factor?

• A. Occlusal forces
• B. Thermal cycling
• C. Surface roughness
• D. Cement retaining the restoration

Answer: (D)

Pulpal response to cast restorations is most directly driven by the chemical environment created by the luting cement that seals the crown to the tooth. The cement sits between the tooth structure and the metal casting, and any irritants it releases or acids it contains can diffuse through dentin and reach the pulp, especially if dentin is thin or margins are close to the pulp. This makes the cement retaining the restoration the primary factor affecting the pulp in this situation.

Occlusal forces can contribute to pulpal stress if there is traumatic occlusion, but with proper adjustment, they are managed and are not the immediate source of pulpal irritation in the context of cementation. Thermal cycling and surface roughness influence other aspects like dentin sensitivity, wear, or plaque-related changes, but they are less likely to cause direct pulpal irritation compared to the chemical interaction at the tooth–cement interface.