Iatrogenic damage to approximal surfaces in contact with Class II restorations.
Medeiros VA1, Seddon RP.
This study investigated the frequency of iatrogenic damage to approximal surfaces in contact with Class II restorations.
Patients (n = 28) with a Class II restoration in contact with an unrestored surface had elastic separators fitted interproximally. Contralateral (unrestored) control surfaces were also separated. Impressions (light body polyvinylsiloxane) of the separated surfaces were taken 3-6 days later. Interproximal impressions (28 paired, seven unpaired) were examined by binocular microscope and scanning electron microscope (SEM) for iatrogenic damage, attrition and cavitation due to caries.
49-60% of surfaces adjacent to Class II restorations had been iatrogenically damaged. The most frequent types of damage were vertical grooves (26%), extensive damage (17%), indentations (6%) and scratches (6%). Damage was more frequent in maxillary teeth (61%) than mandibular teeth (25%), in permanent teeth (60%) more than deciduous teeth (20%). Qualified dentists produced more iatrogenic damage (64%) than undergraduate students (23%).
The frequency of iatrogenic damage to approximal surfaces following Class II preparations was 49%, and possibly as much as 60% when questionably damaged surfaces were included. Protection of the adjacent enamel is of paramount importance during Class II cavity preparation.
To view full text article: https://www.ncbi.nlm.nih.gov/pubmed/10666967
Iatrogenic damage to adjacent teeth during classical approximal box preparation.
Lussi A., Gygax M.
Cutting and finishing approximal preparations with conventional instrumentation and methods may produce iatrogenic damage in adjacent tooth surfaces which subsequently requires restoration. The objective of this investigation was to determine the occurrence of iatrogenic damage and whether, under everyday working conditions in dental practice, such damage could be reduced significantly by using an alternative method and instrumentation designed especially for the purpose.
Dental practitioners were asked to take impressions of teeth scheduled for Class II amalgam restorations. One group (control) prepared the teeth with conventional rotary instrumentation (n = 71), while the test group used a new method and instrumentation (n = 63). These comprised a set of files, a right-angle handpiece with reduced stroke, 36 fixed (rotation-locked) positions for the files and a cylindrical bur with a recessed front-end cutting surface. Damage to the adjacent teeth was assessed under a stereomicroscope.
Using conventional methods, all adjacent tooth surfaces showed damage, often exposing deep layers of dental tissues. There was a clinical and statistically significant reduction of incidence and severity of iatrogenic preparation trauma in the test group.
It appears that conventional approximal box preparation results in significant damage to adjacent tooth surfaces. With the system tested, damage to adjacent tooth surfaces during preparation of proximal boxes can be significantly reduced. This should have an impact on the subsequent rate of restoration for the adjacent surfaces.
To view full text article: https://www.ncbi.nlm.nih.gov/pubmed/9699434
Influence of Four Different Matrix Types on Contact Tightness and Overhang on Class II Composite Restoration - An In - Vitro Study
Priyanka Choudaha, Sanjeev Tyagi , Swapna Munaga, Muktishree Mahendra, Kuldeep Singh Rana, Medha Bhusan & Poonam Rana, National Journal of Medical and Dental Research, 2015
To view full text article: http://njmdr.co.in/admin/upload/1444994897-Research-Article_Priyanka.pdf
Progression of Approximal Caries in Relation to Iatrogenic Preparation Damage
V. Qvist, L. Johannessen & M. Bruun, Journal of Dental Research, 1992
To view full text article: http://jdr.sagepub.com/content/71/7/1370.short
Minimally Invasive Dentistry--concepts and techniques in cariology.
Ericsson, Kidd, McComb & Noack, Oral health prev. dent, 2003
To view full text article: http://www.ncbi.nlm.nih.gov/pubmed/15643750
Proximal Marginal Overhang of Composite Restorations in Relation to Placement Technique of Separation Rings
Loomas, Opdam, Roeters & Huysmans, Operative Dentistry, 2012
To view full text article: http://www.jopdentonline.org/doi/pdf/10.2341/10-286-L