An In-vitro Evaluation of Iatrogenic Damage to the Adjacent Teeth During Crown And Bridge Preparation

Objectives: The aim of the study was to determine the frequency of different types, degree and location of iatrogenic damage to the adjacent teeth during crown and bridge preparations.

Methods: A cross-sectional study was conducted in Aga Khan University Hospital dental clinics from X to Y in which a total of 150 dental casts fulfilling the inclusion criteria were analyzed using non-probability convenient sampling. The casts were examined using 3.5X magnifying loupes for the location, degree and type of damage to the proximal teeth surfaces using Moonpar and Faulkner criteria. Data were analyzed by using SPSS version 22.0 Chi square test was used to assess the association between the experience of practitioner and degree of damage to the adjacent teeth. Inter-examiner reliability was assessed by using kappa statistics. Level of significance was kept at 0.01.

Results: A high prevalence of damage to the proximal surface of adjacent teeth (78% on mesial tooth and 60.6% on distal tooth) was observed, with the majority (32.6%) belonging to the mild categories. Experience of the clinician was significantly associated with proximal surface (mainly mesial) moreover, more severe damages were observed in the mandibular teeth compared to the maxillary.

Conclusions: A high frequency of iatrogenic damage to the adjacent teeth has been found during crown and bridge work with the middle third of the tooth as the most susceptible site. However, the majority of damage was of milder variety including abrasions.