Comparative analysis of the clinical techniques used in evaluation of marginal accuracy of cast restoration using stereomicroscopy as gold standard

PURPOSE This study assessed the effect of preparation design on marginal adaptation and also compared the sensitivity and specificity of clinical evaluation techniques for marginal accuracy of cast restorations to stereomicroscopy. MATERIALS AND METHODS Three Ivorine molar teeth of different designs were prepared. (A)-A complete crown preparation with buccal shoulder and beveled finish line. (B)-A complete crown preparation with chamfer finish line. (C)-A three-quarter crown preparation with proximal boxes and beveled finish line. Twenty four castings were prepared with eight castings for each design respectively. Each casting underwent examination with an explorer, disclosing media, and a stereomicroscope. Stereomicroscopy at a value less than or equal to 30 microns was used as a gold standard to evaluate the significance of different designs on marginal adaptation. Chi-square tests of independence and Kruskal-Wallis were used to evaluate the effect of preparation design and compare the agreement between examination methods for detection of marginal gap size of greater than or equal to 30 microns (α=.05). Sensitivity and specificity for explorer and disclosing media as compared to stereomicroscope was calculated using statistical formula given by Park. RESULTS The preparation design did not significantly affect overall marginal adaptation. Examination by explorer and disclosing media at 30 µm revealed 39% and 10.06% sensitivity and 91% and 82% specificity respectively. CONCLUSION Preparation designs examined in this study did not significantly affect the marginal adaptation of the castings. Commonly used clinical evaluation techniques using explorer and disclosing media appeared to be inadequate for assessment of marginal accuracy.