Journal of Dental Research, Vol 71, 1370-1373, Copyright © 1992 by International & American Associations for Dental Research Online Journals
Progression of approximal caries in relation to iatrogenic preparation damage
V. Qvist, L. Johannessen and M. Bruun
Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
The aim of the present study was to evaluate the effect of iatrogenic
preparation damage on the need for operative caries treatment of approximal
surfaces, adjacent to Class II amalgam restorations. The material was
collected by 77 dentists from the Public Dental Child Health Service in
Denmark. It consisted of die-stone models of 187 first-time Class II
preparations, adjacent to 190 unfilled approximal surfaces of 58 primary
and 132 permanent teeth. The cavity preparations were performed in children
between 4 and 17 years of age. They were all filled with amalgam.
Information about operative treatment and exfoliation or extraction of the
preparation teeth and the adjacent teeth during the following seven years
was obtained from the patients' records. Stereomicroscopic examination of
the models revealed preparation damage on 64% of the unfilled approximal
surfaces in primary teeth and on 69% of the corresponding test surfaces in
permanent teeth. During the observation period, operative treatment was
performed on 10% of the undamaged test surfaces in primary teeth and on 35%
of the damaged ones (p less than 0.05). The corresponding figures for test
surfaces in permanent teeth were 6% and 15% (p less than 0.05). It is
concluded that iatrogenic preparation damage is a frequent side-effect of
operative intervention with approximal caries lesions, and represents a
dental health problem, since the damage increases caries progression and
the perceived need for restorative therapy of the adjacent teeth.
