Management of Idiopathic Subgingival Amalgam Hypertrophy–The Common Amalgam Overhang

Chan, Daniel C.N.; Chung, Albert K.H.

doi:10.2341/09-058-t

Cited by 9 publications

(6 citation statements)

References 13 publications

(3 reference statements)

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“…[41][42][43] Overhangs are primarily iatrogenic, caused by poor operator skills and exacerbated by unusual dental morphology. 44 Clinical and radiographic assessments are the most reliable way of diagnosing overhanging margins. 45 In this investigation, no significant correlation between overhangs and approximal secondary caries (p=0.3750) was determined.…”

Section: Discussionmentioning

confidence: 99%

Detection of Caries Around Amalgam Restorations on Approximal Surfaces

Diniz

Cordeiro

Ferreira-Zandoná

2016

Operative Dentistry

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To evaluate the in vitro performance of the International Caries Detection and Assessment System (ICDAS) visual examination, bitewing radiography (BW), and the DIAGNOdent 2190, a pen-type laser fluorescence device (LFpen), in detecting caries around amalgam restorations on approximal surfaces. Approximal surfaces (N=136) of permanent posterior teeth (N=110) with Class II amalgam restorations were assessed twice by two experienced examiners using ICDAS, BW, and LFpen. The occurrence of proximal overhangs was also evaluated. The teeth were histologically prepared and assessed for caries extension. Different cutoff limits for the LFpen were used. Intraexaminer and interexaminer reproducibility showed moderate to good agreement for all the methods (weighted κ/intraclass correlation coefficient=0.40 to 0.87). The specificities at D1 (all visible lesions affecting enamel) and D3 (lesions extended into dentin) were, respectively, 0.41 and 0.82 for ICDAS, 0.70 and 0.82 for BW, and 0.77-0.89 and 0.88-0.94 for LFpen. The sensitivities were 0.80 and 0.52 for ICDAS, 0.56 and 0.51 for BW, and 0.04-0.23 and 0.01-0.02 for LFpen at D1 and D3, respectively. At the D1/D3 thresholds, the accuracy and the area under the receiver operating characteristic curve (Az) values were similar and statistically higher for ICDAS (0.65/0.68 and 0.633/0.688) and BW (0.64/0.68 and 0.655/0.719), respectively; whereas, LFpen presented lower accuracy (0.37-0.44/0.49-0.52) and Az (0.390-0.454/0.345-0.395) values. The occurrence of overhangs (26.8%) was shown to be irrelevant in determining the presence of secondary caries. The ICDAS and BW methods presented the best performance in detecting caries lesions affecting enamel and dentin on approximal surfaces of amalgam restorations.

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Section: Discussionmentioning

confidence: 99%

Detection of Caries Around Amalgam Restorations on Approximal Surfaces

Diniz

Cordeiro

Ferreira-Zandoná

2016

Operative Dentistry

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“…Another reason has been cited to be the morphologic variation in the cervical aspect of teeth, which can impede the appropriate placement of the matrix band and wedge in complete conformity to gingival cavo-margin. 15,16 There is no doubt that bacterial plaque causes gingival inflammation. Yet, many predisposing factors, such as overhang, can aggravate the condition.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Three Different Instruments in the Removal of Amalgam Overhang: An In Vitro Study

Reza

Tavangar

Bardia

et al. 2019

The Journal of Contemporary Dental Practice

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Aim:Overhang is the extension of restorative material beyond the cavity preparation. It changes sulcus microflora into organisms conducive to chronic periodontitis. After overhang removal the gingival index and microflora return to a healthy state. This can also improve access for dental plaque removal. The aim of this study was to compare the efficacy of three different instruments in association with amalgam overhang removal. Materials and methods:One hundred thirty-five intact premolars were selected. The teeth were restored with amalgam such that restorations had 1 mm overhangs. Overhangs were removed employing three different instruments in three groups: sickle scaler, ultrasonic scaler, and diamond flame bur. A stereomicroscope was utilized to evaluate both the level of smoothness in the restored area, tooth damage and probable gaps. The data were analyzed using post hoc and Chi-square. Results:The minimum and maximum time of removal were respectively obtained by ultrasonic scaler and sickle scaler, which was statistically significant (p <0.0001). Also, smoothness of the restored area in the sickle scaler group was significantly less than the other methods (p <0.0001).The percentage of tooth damage in the diamond flame bur group was significantly greater than the others (p <0.0001). The data concerning gap size showed no significant difference. Conclusion:Ultrasonic scaler causes no significant damage to the tooth during an overhang removal procedure. In addition, it offers an acceptable level of surface smoothness in restorations and decreases the required time for overhang removal.Clinical significance: Ultrasonic scaler can be recommended as an effective instrument for amalgam overhang removal.

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“…X-rays: Dental segment Dick x-rays were selected according to the following criteria: on each radiograph at least three teeth to be present with at least two fi llings (n = 632) and all to be analyzed under magnifi cation x5. According to the size of the overhang and to the detected pathology the restored teeth were placed in six groups: small, middle, large and in each one of them two subgroups were formedwith and without changes in the interdental septum of the bone [4,6].…”

Section: Methodsmentioning

confidence: 99%

“…The severity of the problem varies in different countries and in different dental practices. Some authors found the proportion of amalgam overhangs to be 16 to 71% of all restorations (Chan 2009). D. C. Chan (2009) found that 57% have at least one fi lling with overhang, 27% three or more, in 235 x-rays with 1,787 proximal restorations.…”

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confidence: 99%

Frequency of Iatrogenic Changes Caused from Overhang Restorations

Boteva

Karayasheva

Peycheva

2015

Acta Medica Bulgarica

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Summary Overhangs from different restorations are an iatrogenic error with different results, short and long term consequences related to bone changes and periodontal diseases. Amalgam “tattoos”, idiopathic subgingival hypertrophy, marginal periodontitis and bone reductions in the intradental septum are major problems. The aim of the present study is to evaluate the frequency of traumatic restorations in distal teeth and clinical criteria, related to the x-ray findings. Evaluating criteria, for repairing the overhangs or for replacement of the restorations, is also a goal. Three hundred and sixteen - 316 patients from both sexes, 632 dental x-rays with 948 distal teeth and 632 restorations, at least two radiographs for each patient, were analyzed. Overhangs are classified in three groups: small, middle and large. In the criteria bone changes from the overhangs are analyzed separately from the existing or nonexisting bone changes from a generalized periodontal diseases. The frequency of iatrogenic changes in this cohort group is 10.6% from 632 restored teeth. This is a relatively small number compared with the other published studies. These overhangs are on distal teeth in sound teeth arches which makes them difficult for corrections. The evaluated criteria for replacement based on x-ray findings and clinical experience includes: operative and nonoperative corrections, restoration replacement, perio- and endo-therapy and follow up terms for secondary caries.

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Management of Idiopathic Subgingival Amalgam Hypertrophy–The Common Amalgam Overhang

Cited by 9 publications

References 13 publications

Detection of Caries Around Amalgam Restorations on Approximal Surfaces

Detection of Caries Around Amalgam Restorations on Approximal Surfaces

Comparison of the Efficacy of Three Different Instruments in the Removal of Amalgam Overhang: An In Vitro Study

Frequency of Iatrogenic Changes Caused from Overhang Restorations

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