The impact of magnification on the visual assessment of composite fillings

Abstract

Introduction. Evaluating the quality of composite restorations is an essential element of the clinical examination and is typically performed using a dental mirror and the light from the dental unit. The use of both tactile instruments (e.g., dental probes of various diameters) and magnifying devices, such as loupes and microscopes, is acceptable, but their superiority over visual examination remains controversial. Aim. The aim of the study was to perform a comparative visual assessment of selected parameters of composite restorations, performed with and without the use of magnification. Material and methods. The study involved 26 fourth-year students of the Faculty of Medicine and Dentistry at the Medical University of Warsaw. They were randomly divided into three groups. Each group assessed two Black Class I restorations located on the occlusal surfaces of teeth 26 and 36. Assessments based on the modified Ryge scale addressed the following characteristics: anatomical shape, color matching, surface smoothness, marginal integrity, and the presence of secondary caries. Each characteristic (except secondary caries) was scored on a scale from 0 (no defect) to 3 (severe defect). The examination was conducted in a dental office under artificial lighting using a dental mirror and the magnification of a surgical microscope (with built-in LED lighting) and dental loupes. Results. The study found no significant differences between the assessment methods for the following characteristics: anatomical shape, surface smoothness, marginal integrity, and secondary caries. However, for color matching, there was a tendency for lower scores (better match) when assessed using a microscope. Conclusions. The tendency for lower assessments using a microscope may be due to its specific lighting characteristics and limited field of view. The lack of statistically significant differences between the methods suggests that, under routine conditions, assessment with the naked eye or magnifying glasses may be sufficient. Although no significant differences were found between the different examination methods, it appears that during the educational phase of dental students, the use of magnification leads to a more accurate assessment of restorations and, consequently, more informed decisions regarding their repair or replacement.