Effect of iatrogenic factors on periodontal health: An epidemiological study

Periodontitis is a multifactorial disease. Among conglomerate etiological factors, overhanging interproximal restorations are viewed as contributing factors causing gingival inflammation due to their retentive capacity for bacterial plaque leading to periodontal destruction. Hence this study is intended to determine the prevalence of overhanging restorations and its effect on periodontal status of the teeth and to assess the iatrogenic effects of overhanging margins on periodontal health.

A total of 100 subjects of 15-65 years of age were recruited for this study. Dental restorations which affect periodontal health like amalgams, composite or glass ionomer restorations (overhanging margins proximally), fixed prosthesis, cervical abrasions, class V restorations extending sub-gingivally were included in the study. Patients with known systemic diseases, smokers, and on any medication in past 6 months were excluded from the study. Various parameters like bleeding on probing, probing depth, clinical attachment loss, biological width, gingival recession, duration of restoration were assessed according to the site of the restorations.

A commercially available SPSS version 20.0 Software, was used to perform the statistical analysis. The data were distributed normally and it was investigated using paired t-test. The prevalence of overhanging restorations was done through percentages comparison between restorative sites with non-restorative sites.

The presence of sub-gingival restorations was greater in males than in females. This can be attributed to the oral hygiene maintenance of the subjects. The prevalence of sub-gingival restorations was more prevalent in the age groups between 35 and 45 years of age.

This study clearly identified a higher prevalence, 50.8% of sub-gingival restorations causing gingivitis and has shown significant influence on periodontal status of the tooth.