Is it the end of the road for dental amalgam? A critical review

Abstract

The longevity of dental restorations is dependent on many factors, including those related to materials, the dentist, and the patient. Dental amalgams have successfully served the profession for over a century. The main reasons for restoration failure are secondary caries, fracture of the bulk of the restoration or of the tooth, and marginal deficiencies and wear. The importance of direct-placement, aesthetic, tooth-colored restorative materials is still increasing. Amalgam restorations are being replaced because of alleged adverse health effects and inferior aesthetic appearance. All alternative restorative materials and procedures, however, have certain limitations. This article will attempt to critically analyse both amalgams and resin based composites, through an evaluation of scientific literature.

Keywords: Composite resins; dental amalgam; failure; longevity.

Figure 1

15 year old amalgam restoration in 36 which shows some evidence of corrosion and extrusion but continues to function efficiently

Figure 2

35 disto-occlusal restoration at 10 years

Figure 3

Well polished amalgam restoration in perfect shape after 10 years of service. No evidence of corrosion, marginal discrepancy and secondary caries

Figure 4

Disto occlusal composite restoration in 15

Figure 5

15 and 16 restorations at 3 years in perfect function, showing minimal discoluration

Figure 6

Multiple large composite restorations at 7 years. 16 MOD showing signs of marginal discolouration , wear and secondary caries.17 multi surface restoration still in good shape

Figure 7

46 glass ionomer disto-occlusal restoration showing bulk fracture

Figure 8

Fractured restoration replaced with Silorane based composite (P 90,3MESPE)