Assessment of iatrogenic damage to proximal surfaces of adjacent teeth following crown preparation by final year dental students in Saudi Arabia

Abstract

Aim: The purpose of the following study is to measure the amount and frequency of iatrogenic damage to inter-proximal surfaces of adjacent teeth, following crown preparation, among undergraduate dental students in Riyadh Colleges of Dentistry and Pharmacy. Materials and Methods: Teeth surfaces were examined on master casts, using ×2.5 magnifying loupes. The damage depth of the injured teeth was measured, with - a modified digital micrometer caliper (Whitworth's 6 inch Digital Caliper). To ensure that examined teeth surfaces were intact pre-operatively, they were confirmed with pretreatment radiographs. Results: A sample of 180 teeth surfaces chosen randomly was examined of which only 111 samples done by undergraduate students with intact teeth surfaces were included. The 69 excluded samples either had carious or restored teeth surfaces or were done by practitioners other than dental students. Over Nearly 98% of examined teeth surfaces, adjacent to crown prepared teeth, were proximally injured. Through using specific measuring parameters, the most frequent type of damage was abrasion (58.7%). The most commonly damaged area found was the middle-third of the proximal surface. The damage extended to more than 50% of the proximal surface, in 63% of the total sample. The depth of the injury was more than 0.1 mm in 58% of the total sample. Damage was more frequent in maxillary teeth (60.4%), than mandibular teeth (39.6%). Conclusion: Conventional crown preparation methods appear to result in significant damage to adjacent teeth surfaces; increasing caries risk potential, thermal sensitivity and periodontal disease. Therefore, protection of these surfaces and selection of the most appropriate instruments and preparation techniques are important.