DT News - MEA - A clinical case using the Palodent® V3 Sectional Matrix System

Prof. Dr. A. Lussi Bern, Switzerland

Mon. 4 March 2019

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Adjacent teeth damaged by dental bur

Objective
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.

Method
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 rightangle 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.

¹ Palodent® Plus was re-branded to Palodent® V3 in 2015.

Insert Palodent® V31 WedgeGuard before starting preparation

WedgeGuard protects adjacent tooth during preparation

Remove plate from WedgeGuard, wedge remains

Initial Case. Proximal caries on the distal area of the first lower molar.

Insertion of the Palodent® V3 WedgeGuard before tooth preparation.

Cavity preparation and the Palodent® V3 system in place.

Palodent® V3 WedgeGuard showing damage caused to the WedgeGuard (and not the adjacent tooth) after tooth preparation.

Results
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.

Conclusion
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.

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