Evaluation of Proximal Surface Damage from Iatrogenic Causes during Abutment Preparation: A Comparative Study

Abstract

Background: Iatrogenic damage during abutment preparation in fixed prosthodontics can compromise adjacent tooth structures. Understanding the extent of such damage associated with different preparation techniques is essential for optimizing clinical outcomes. Objective: This study aimed to evaluate proximal surface damage resulting from iatrogenic factors during abutment preparation, comparing three commonly used techniques. Study Design: A comparative study design. Settings: Department of Cardiology at National Institute of Cardiovascular Diseases (NICVD) Karachi, Pakistan. Duration: From 1^st Jan 2022 to 1^st June 2022. Methods: A total of 135 patients were enrolled, randomly assigned to three groups: Group A (conventional diamond bur), Group B (high-speed carbide bur), and Group C (guided preparation technique with protective strips). Proximal surface damage was assessed using scanning electron microscopy (SEM), and damage scores were recorded on a scale from 0 to 4. Statistical analysis was performed using ANOVA and post-hoc tests. Results: The guided preparation technique (Group C) demonstrated significantly lower damage scores (mean score 1.5) compared to both the conventional diamond bur (Group A, mean score 2.8) and the high-speed carbide bur (Group B, mean score 3.5). Only 15% of specimens in Group C exhibited significant damage, while 60% of Group B showed severe damage. Conclusion: The choice of abutment preparation technique significantly affects the risk of iatrogenic damage to adjacent tooth surfaces. The guided preparation technique proved to be the most effective in minimizing such damage.