Pattern of Iatrogenic Damage to Approximal Tooth Surface during Class II Cavity Preparation in a Clinically Simulated Environment

Abstract

Background/Aim: Iatrogenic tooth damage is a well recognized and longstanding problem that appears to have refused to disappear from restorative clinical practice. This study was designed to determine the pattern of distribution of iatrogenic tooth surface damage caused by a cross section of dental students and residents during Class II cavity preparation in a clinical simulated environment.

Methods: Residents rotating through the Department of Restorative Dentistry and randomly selected 1st year and final year dental undergraduates were told to prepare either mesio-occlusal or disto-occlusal Class II cavity on pre-selected normal upper plastic posterior tooth mounted on phantom head after obtaining inform consent. The type of preparation that is selected is based on the adjacent tooth surface that is intact. At the end, the location of the damage and the type (Groove; indentation; Scratches; Extensive) as described by Medeiros and Seddon (2000) was evaluated under a magnifying lens. Summary statistics was generated.

Results: The frequency of iatrogenic tooth damage was 100% and “indentation” was the commonest pattern, followed by grooves. More damages occurred in the cervical area. Extensive damage formed 19.0% of the total damages and this type of damage was found more adjacent to MO cavity (25.0%) compare to DO (15.4%) but there was no difference between the extensive damage that occurred on the right and left sides.

Conclusion: The frequency of iatrogenic tooth damage was 100% and indentation was the commonest pattern. Extensive type of damage was found more adjacent to MO cavity.

Keywords: Iatrogenic tooth damage, approximal tooth surface, Class II cavity