DETERMINANTS OF QUALITY IN OPERATIVE DENTISTRY

The definition of quality in operative dentistry has often, at least i n part, been related to how well a cut preparation compares with an id eal preparation. The ideal preparation follows well-defined design pri nciples. These design principles have their roots in empirical dentist ry and scientific evaluations, the latter often being conducted in vit ro. Because of the complexity of following these design principles pra ctically a large portion of dental education consists of perfecting ca vity preparations. By focusing on how to cut these cavity preparations as closely as possible to the ideal preparation, dentists with high p sycho-motor skills have been able to provide the public with restorati ve procedures of high standards over the years. However, because of th e tendency of relating quality in operative dentistry to the ideal pre paration, we found it justifiable to review the literature dealing wit h the cavity design principles of the Class ii amalgam preparation. Wh at triggered this review was a request from the international Dental F ederation (FDI) to start a process leading to a scientifically based q uality definition of dental restorations, a definition that determines how different factors, including cavity design principles, affect the longevity of both tooth and restoration. From our review, we conclude that patient response and restoration performance over time, rather t han how closely a cavity preparation compares with the ideal preparati on, will be of more significance in determining the longevity of a Cla ss II amalgam restoration.