Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 13;8(8):CD005620.
doi: 10.1002/14651858.CD005620.pub3.

Direct composite resin fillings versus amalgam fillings for permanent posterior teeth

Helen V Worthington  1 , Sara Khangura  2 , Kelsey Seal  2 , Monika Mierzwinski-Urban  2 , Analia Veitz-Keenan  3 , Philipp Sahrmann  4 , Patrick Roger Schmidlin  4 , Dell Davis  5 , Zipporah Iheozor-Ejiofor  6 , María Graciela Rasines Alcaraz  7
Affiliations

Direct composite resin fillings versus amalgam fillings for permanent posterior teeth

Helen V Worthington et al. Cochrane Database Syst Rev. .

Abstract

Background: Traditionally, amalgam has been used for filling cavities in posterior teeth, and it continues to be the restorative material of choice in some low- and middle-income countries due to its effectiveness and relatively low cost. However, there are concerns over the use of amalgam restorations (fillings) with regard to mercury release in the body and the environmental impact of mercury disposal. Dental composite resin materials are an aesthetic alternative to amalgam, and their mechanical properties have developed sufficiently to make them suitable for restoring posterior teeth. Nevertheless, composite resin materials may have potential for toxicity to human health and the environment. The United Nations Environment Programme has established the Minamata Convention on Mercury, which is an international treaty that aims "to protect the [sic] human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds". It entered into force in August 2017, and as of February 2021 had been ratified by 127 governments. Ratification involves committing to the adoption of at least two of nine proposed measures to phase down the use of mercury, including amalgam in dentistry. In light of this, we have updated a review originally published in 2014, expanding the scope of the review by undertaking an additional search for harms outcomes. Our review synthesises the results of studies that evaluate the long-term effectiveness and safety of amalgam versus composite resin restorations, and evaluates the level of certainty we can have in that evidence.

Objectives: To examine the effects (i.e. efficacy and safety) of direct composite resin fillings versus amalgam fillings.

Search methods: An information specialist searched five bibliographic databases up to 16 February 2021 and used additional search methods to identify published, unpublished and ongoing studies SELECTION CRITERIA: To assess efficacy, we included randomised controlled trials (RCTs) comparing dental composite resin with amalgam restorations in permanent posterior teeth that assessed restoration failure or survival at follow-up of at least three years. To assess safety, we sought non-randomised studies in addition to RCTs that directly compared composite resin and amalgam restorative materials and measured toxicity, sensitivity, allergy, or injury.

Data collection and analysis: We used standard methodological procedures expected by Cochrane.

Main results: We included a total of eight studies in this updated review, all of which were RCTs. Two studies used a parallel-group design, and six used a split-mouth design. We judged all of the included studies to be at high risk of bias due to lack of blinding and issues related to unit of analysis. We identified one new trial since the previous version of this review (2014), as well as eight additional papers that assessed safety, all of which related to the two parallel-group studies that were already included in the review. For our primary meta-analyses, we combined data from the two parallel-group trials, which involved 1645 composite restorations and 1365 amalgam restorations in 921 children. We found low-certainty evidence that composite resin restorations had almost double the risk of failure compared to amalgam restorations (risk ratio (RR) 1.89, 95% confidence interval (CI) 1.52 to 2.35; P < 0.001), and were at much higher risk of secondary caries (RR 2.14, 95% CI 1.67 to 2.74; P < 0.001). We found low-certainty evidence that composite resin restorations were not more likely to result in restoration fracture (RR 0.87, 95% CI 0.46 to 1.64; P = 0.66). Six trials used a split-mouth design. We considered these studies separately, as their reliability was compromised due to poor reporting, unit of analysis errors, and variability in methods and findings. Subgroup analysis showed that the findings were consistent with the results of the parallel-group studies. Three trials investigated possible harms of dental restorations. Higher urinary mercury levels were reported amongst children with amalgam restorations in two trials, but the levels were lower than what is known to be toxic. Some differences between amalgam and composite resin groups were observed on certain measures of renal, neuropsychological, and psychosocial function, physical development, and postoperative sensitivity; however, no consistent or clinically important harms were found. We considered that the vast number of comparisons made false-positive results likely. There was no evidence of differences between the amalgam and composite resin groups in neurological symptoms, immune function, and urinary porphyrin excretion. The evidence is of very low certainty, with most harms outcomes reported in only one trial.

Authors' conclusions: Low-certainty evidence suggests that composite resin restorations may have almost double the failure rate of amalgam restorations. The risk of restoration fracture does not seem to be higher with composite resin restorations, but there is a much higher risk of developing secondary caries. Very low-certainty evidence suggests that there may be no clinically important differences in the safety profile of amalgam compared with composite resin dental restorations. This review supports the utility of amalgam restorations, and the results may be particularly useful in parts of the world where amalgam is still the material of choice to restore posterior teeth with proximal caries. Of note, however, is that composite resin materials have undergone important improvements in the years since the trials informing the primary analyses for this review were conducted. The global phase-down of dental amalgam via the Minamata Convention on Mercury is an important consideration when deciding between amalgam and composite resin dental materials. The choice of which dental material to use will depend on shared decision-making between dental providers and patients in the clinic setting, and local directives and protocols.

PubMed Disclaimer

Conflict of interest statement

Helen V Worthington: none known. I am an Editor (and former Co‐ordinating Editor) with Cochrane Oral Health. Sara D Khangura: none known. I was employed by CADTH when working on the review. Kelsey Seal: none known. I was employed by CADTH when working on the review. Monika Mierzwinski‐Urban: none known. I was employed by CADTH when working on the review. Analia Veitz‐Keenan: none known. Philipp Sahrmann: none known Patrick Roger Schmidlin: none known Dell Davis: none known Zipporah Iheozor‐Ejiofor: none known. I was employed by Cochrane Oral Health when working on the review. María Graciela Rasines Alcaraz: none known

Figures

1
1
Updated flow diagram 2021
2
2
Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: Composite resin fillings versus amalgam fillings, Outcome 1: Failure rate
1.2
1.2. Analysis
Comparison 1: Composite resin fillings versus amalgam fillings, Outcome 2: Secondary caries
1.3
1.3. Analysis
Comparison 1: Composite resin fillings versus amalgam fillings, Outcome 3: Fracture of restorations
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Casa Pia 2007 {published data only}
    1. Bernardo M, Luis H, Martin MD, Leroux BG, Rue T, Leitão J, et al. Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. Journal of the American Dental Association 2007;138(6):775-83. [PMID: PMID: 17545266] - PubMed
    1. DeRouen TA, Martin MD, Leroux BG, Townes BD, Woods JS, Leitao J, et al. Neurobehavioural effects of dental amalgam in children: a randomised clinical trial. JAMA 2006;295(15):1784-92. [PMID: PMID: 16622140] - PubMed
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A dose-dependent relationship between mercury exposure from dental amalgams and urinary mercury levels: a further assessment of the Casa Pia Children's Dental Amalgam Trial. Human & Experimental Toxicology 2012;31(1):11-7. [PMID: PMID: 21803780] - PubMed
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers: a further assessment of the Casa Pia children's dental amalgam trial. Human & Experimental Toxicology 2013;32(4):434-40. [PMID: PMID: 22893351] - PubMed
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant relationship between mercury exposure from dental amalgams and urinary porphyrins: a further assessment of the Casa Pia children's dental amalgam trial. Biometals 2011;24(2):215-24. [PMID: PMID: 21053054] - PubMed
Cunningham 1990 {published data only}
    1. Cunningham J, Mair LH, Foster MA, Ireland RS. Clinical evaluation of three posterior composite and two amalgam restorative materials: 3-year results. British Dental Journal 1990;169(10):319-23. [PMID: PMID: 2271308] - PubMed
Hendriks 1986 {published data only}
    1. Hendriks FH, Letzel H, Vrijhoef MM. Composite versus amalgam restorations. A three-year clinical evaluation. Journal of Oral Rehabilitation 1986;13(5):401-11. [PMID: PMID: 3464721] - PubMed
Kemaloglu 2016 {published data only}
    1. Kemaloglu H, Pamir T, Tezel H. A 3-year randomized clinical trial evaluating two different bonded posterior restorations: amalgam versus resin composite. European Journal of Dentistry 2016;10(1):16-22. [DOI: 10.4103/1305-7456.175692] - PMC - PubMed
Letzel 1989 {published data only}
    1. Letzel H. Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial. Journal of Dentistry 1989;17(Suppl 1):S10-7. [PMID: PMID: 265963] - PubMed
NECAT 2007 {published data only}
    1. Barregard L, Trachtenberg F, McKinlay S. Renal effects of dental amalgam in children: the New England children's amalgam trial. Environmental Health Perspectives 2008;116(3):304-9. - PMC - PubMed
    1. Bellinger DC, Daniel D, Trachtenberg F, Tavares M, McKinlay S. Dental amalgam restorations and children's neuropsychological function: the New England Children's Amalgam Trial. Environmental Health Perspectives 2007;115(3):440-6. - PMC - PubMed
    1. Bellinger DC, Trachtenberg F, Zhang A, Tavares M, Daniel D, McKinlay S. Dental amalgam and psychosocial status: the New England Children's Amalgam Trial. Journal of Dental Research 2008;87(5):470-4. - PMC - PubMed
    1. Maserejian NN, Hauser R, Tavares M, Trachtenberg FL, Shrader P, McKinlay S. Dental composites and amalgam and physical development in children. Journal of Dental Research 2012;91(11):1019-25. [PMID: PMID: 22972857] - PMC - PubMed
    1. Maserejian NN, Trachtenberg FL, Hauser R, McKinlay S, Shrader P, Tavares M, et al. Dental composite restorations and psychosocial function in children. Pediatrics 2012;130:328-38. [PMID: PMID: 22802599] - PMC - PubMed
Norman 1990 {published data only}
    1. Norman RD, Wright JS, Rydberg RJ, Felkner LL. A 5-year study comparing a posterior composite resin and an amalgam. Journal of Prosthetic Dentistry 1990;64(5):523-9. [PMID: PMID: 2090809] - PubMed
Robinson 1988 {published data only}
    1. Robinson AA, Rowe AH, Maberley ML. A three-year study of the clinical performance of a posterior composite and a lathe cut amalgam alloy. British Dental Journal 1988;164(8):248-52. [PMID: PMID: 3164193] - PubMed

References to studies excluded from this review

Allan 1977 {published data only}
    1. Allan DN. A longitudinal study of dental restorations. British Dental Journal 1977;143(3):87-9. [PMID: PMID: 268962] - PubMed
Bellinger 2006 {published data only}
    1. Bellinger DC, Trachtenberg F, Barregard L, Tavares M, Cernichiari E, Daniel D, et al. Neuropsychological and renal effects of dental amalgam in children: a randomized clinical trial. JAMA 2006;295(15):1775-83. [ClinicalTrials.gov: NCT00065988] [PMID: PMID: 16622139] - PubMed
Borgmeijer 1991 {published data only}
    1. Borgmeijer PJ, Kreulen CM, Amerongen WE, Akerboom HB, Gruythuysen R. The prevalence of postoperative sensitivity in teeth restored with Class II composite resin restorations. ASDC Journal of Dentistry for Children 1991;58(5):378-83. [PMID: PMID: 1939803] - PubMed
Bryant 1994 {published data only}
    1. Bryant RW, Hodge KL. A clinical evaluation of posterior composite resin restorations. Australian Dental Journal 1994;39(2):77-8. [PMID: PMID: 8018063] - PubMed
Busato 1996 {published data only}
    1. Busato ALS, Baldissera RA, Barbosa AN, Bueno M. The clinical evaluation of the composite resins and amalgam restorations in molars and premolars [Avaliaçäo clínica de restauraçöes de resina composta e amálgama em dentes posteriores - 5 anos]. Revista Brasileira de Odontologia 1996;53(3):30-5. [ LILACS ID: lil-187592]
Cloyd 1997 {published data only}
    1. Cloyd S, Gilpatrick RO, Moore D. Preventive resin restorations vs. amalgam restorations: a three-year clinical study. Journal of the Tennessee Dental Association 1997;77(4):36-40. [PMID: PMID: 9520761] - PubMed
Collins 1998 {published data only}
    1. Collins CJ, Bryant RW, Hodge KL. A clinical evaluation of posterior composite resin restorations: 8-year findings. Journal of Dentistry 1998;26(4):311-7. [PMID: PMID: 9611936] - PubMed
Dilley 1990 {published data only}
    1. Dilley DC, Vann WF Jr, Oldenburg TR, Crisp RM. Time required for placement of composite versus amalgam restorations. ASDC Journal of Dentistry for Children 1990;57(3):177-83. [PMID: PMID: 2345211] - PubMed
Eames 1974 {published data only}
    1. Eames WB, Strain JD, Weitman RT, Williams AK. Clinical comparison of composite, amalgam, and silicate restorations. Journal of the American Dental Association 1974;89(5):1111-7. [PMID: PMID: 4529964] - PubMed
Fukushima 1988 {published data only}
    1. Fukushima M, Setcos JC, Phillips RW. Marginal fracture of posterior composite resins. Journal of the American Dental Association 1988;117(5):577-83. [PMID: PMID: 3066806] - PubMed
Hendriks 1985 {published data only}
    1. Hendriks FH, Letzel H, Vrijhoef MM. Cost benefit analysis of direct posterior restorations. Community Dentistry and Oral Epidemiology 1985;13(5):256-9. [PMID: PMID: 3931963] - PubMed
Johnson 1992 {published data only}
    1. Johnson GH, Bales DJ, Gordon GE, Powell LV. Clinical performance of posterior composite resin restorations. Quintessence International 1992;23(10):705-11. [PMID: PMID: 1289954] - PubMed
Knibbs 1992 {published data only}
    1. Knibbs PJ, Smart ER. The clinical performance of a posterior composite resin restorative material, Heliomolar R.O.: 3-year report. Journal of Oral Rehabilitation 1992;19(3):231-7. [PMID: PMID: 1500966] - PubMed
Kopperud 2012 {published data only}
    1. Kopperud SE, Tveit AB, Gaarden T, Sandvik L, Espelid I. Longevity of posterior dental restorations and reasons for failure. European Journal of Oral Science 2012;120:539-48. - PubMed
Koray {published data only}
    1. Koray F, Murray PE, Garcia-Godoy F. Clinical performance of amalgam and composite restorations. Istanbul University, Faculty of Dentistry, Department of Conservative Dentistry, Turkey; Istanbul University, Faculty of Medicine, Department of Biostatistic, Turkey (unpublished).
Kreulen 1993a {published data only}
    1. Kreulen CM, Van Amerongen WE, Gruythuysen RJ, Borgmeijer PJ, Akerboom HB. Prevalence of postoperative sensitivity with indirect Class II resin composite inlays. ASDC Journal of Dentistry for Children 1993;60(2):95-8. [PMID: PMID: 8486862 ] - PubMed
Kreulen 1993b {published data only}
    1. Kreulen CM, Van Amerongen WE, Borgmeijer PJ, Akerboom HB. Comparison of two methods for evaluating the occlusal marginal adaptation of posterior restorations. ASDC Journal of Dentistry for Children 1993;60(4-5):304-9. [PMID: PMID: 8258574] - PubMed
Lambrechts 1984 {published data only}
    1. Lambrechts P, Vanherle G, Vuylsteke M, Davidson CL. Quantitative evaluation of the wear resistance of posterior dental restorations: a new three-dimensional measuring technique. Journal of Dentistry 1984;12(3):252-6. [PMID: PMID: 6593340] - PubMed
Leinfelder 1975 {published data only}
    1. Leinfelder KF, Sluder TB, Sockwell CL, Strickland WD, Wall JT. Clinical evaluation of composite resins as anterior and posterior restorative materials. Journal of Prosthetic Dentistry 1975;33(4):407-16. [PMID: PMID: 1054419] - PubMed
Leinfelder 1980 {published data only}
    1. Leinfelder KF, Sluder TB, Santos JFF, Wall JT. Five-year clinical evaluation of anterior and posterior restorations of composite resin. Operative Dentistry 1980;5(2):57-65. [PMID: PMID: 9539464]
Mair 1995 {published data only}
    1. Mair LH. Wear patterns in two amalgams and three posterior composites after 5 years' clinical service. Journal of Dentistry 1995;23(2):107-12. [PMID: PMID: 7738266] - PubMed
Mair 1998 {published data only}
    1. Mair LH. Ten-year clinical assessment of three posterior resin composites and two amalgams. Quintessence International 1998;29(8):483-90. [PMID: PMID: 9807127] - PubMed
Mannocci 2005 {published data only}
    1. Mannocci F, Qualtrough AJ, Worthington HV, Watson TF, Pitt Ford TR. Randomized clinical comparison of endodontically treated teeth restored with amalgam or with fiber posts and resin composite: five-year results. Operative Dentistry 2005;30(1):9-15. [PMID: PMID: 15765952] - PubMed
Mjör 1993a {published data only}
    1. Mjör IA, Jokstad A. Five-year study of Class II restorations in permanent teeth using amalgam, glass polyalkenoate (ionomer) cement and resin-based composite materials. Journal of Dentistry 1993;21(6):338-43. [PMID: PMID: 8258583] - PubMed
Mjör 1993b {published data only}
    1. Mjör IA, Um CM. Survey of amalgam and composite restorations in Korea. International Dental Journal 1993;43(4):311-6. [PMID: PMID: 8276514] - PubMed
Nell 1994 {published data only}
    1. Nell A, Ferenz C, Sperr W. The behavior of gingiva at supra- and subgingival preparation margins by using amalgam and composite as filling material [Verhalten der Gingiva bei supra-und subgingivalen Präparationsrändern bei Verwendung von Amalgam und Composite als Füllungsmaterial]. Zeitschrift fur Stomatologie 1994;91(4):173-6.
Pieper 1991 {published data only}
    1. Pieper K, Meyer G, Marienhagen B, Motsch A. A long term study of amalgam and composite fillings [Eine langzeitstudie an amalgam-und kuntstoff-fullugen]. Deutsche Zahnärztliche Zeitschrift 1991;46(3):222-5. [PMID: PMID: 1814726] - PubMed
Powers 1974 {published data only}
    1. Powers JM, Allen LJ, Craig RG. Two-body abrasion of commercial and experimental restorative and coating resins and an amalgam. Journal of the American Dental Association 1974;89(5):1118-22. [PMID: PMID: 4610026] - PubMed
Prati 1988 {published data only}
    1. Prati C, Montanari G. Three-year clinical study of two composite resins and one non-gamma 2 conventional amalgam in posterior teeth. Schweiz Monatsschr Zahnmed 1988;98(2):120-5. [PMID: PMID: 3162608] - PubMed
Roulet 1977 {published data only}
    1. Roulet JF. Clinical comparison of 3 composite resins with amalgam in the region of the posterior teeth [Ein klinischer Vergleich 3-er Komposits mit Amalgam im Seitenzahnbereich]. Deutsches Zahnärzteblatt 1977;86(21):1055-62. [PMID: PMID: 337725] - PubMed
Roulet 1978 {published data only}
    1. Roulet JF, Mettler P, Friedrich U. The abrasion of amalgam and composites in the lateral dental region [Die Abrasion von Amalgam und Komposits im Seitenzahnbereich]. Deutsche Zahnärztliche Zeitschrift 1978;33(3):206-9. [PMID: PMID: 274270] - PubMed
Rowe 1989 {published data only}
    1. Rowe AH. A five year study of the clinical performance of a posterior composite resin restorative material. Journal of Dentistry 1989;17(Suppl 1):6-9. [PMID: PMID: 2659636] - PubMed
Rytömaa 1984 {published data only}
    1. Rytömaa I, Murtomaa H, Turtola L, Lind K. Clinical-assessment of amalgam fillings. Community Dentistry and Oral Epidemiology 1984;12(3):169-72. [PMID: PMID: 6378506] - PubMed
Samaha 1982 {published data only}
    1. Samaha NS. Effect of different composites and amalgam on the gingiva [Die Auswirkung verschiedener Komposite und von Amalgam auf die Gingiva]. Deutsche Zahnärztliche Zeitschrift 1982;37(4):339-43. [PMID: PMID: 7047143] - PubMed
Shenker 2008 {published data only}
    1. Shenker BJ, Maserejian NN, Zhang A, McKinlay S. Immune function effects of dental amalgam in children: a randomized clinical trial. Journal of the American Dental Association 2008;139(11):1496-505. [CENTRAL: PMCID: PMC2908994] [PMID: PMID: 18978388] - PMC - PubMed
Smales 1991 {published data only}
    1. Smales RJ. Long-term deterioration of composite resin and amalgam restorations. Operative Dentistry 1991;16(6):202-9. [PMID: PMID: 1840079] - PubMed
Smales 1992 {published data only}
    1. Smales RJ. Effect of rubber dam isolation on restoration deterioration. American Journal of Dentistry 1992;5(5):277-9. [PMID: PMID: 1299257] - PubMed
Solano 1984 {published data only}
    1. Solano MdaC Pereira Pinto. A comparative study between composite resins and amalgam in Class I cavities of permanent molars [Masters dissertation] [Estudo comparativo entre compósito e amálgama em Classe I de primeiros molares permanentes]. 1984.
Tobi 1999 {published data only}
    1. Tobi H, Kreulen CM, Vondeling H, Amerongen W. Cost-effectiveness of composite resins and amalgam in the replacement of amalgam Class II restorations. Community Dentistry and Oral Epidemiology 1999;27(2):137-43. [PMID: PMID: 10226724] - PubMed
Van Nieuwenhuysen 2003 {published data only}
    1. Van Nieuwenhuysen JP, D'Hoore W, Carvalho J, Qvist V. Long-term evaluation of extensive restorations in permanent teeth. Journal of Dentistry 2003;31(6):395-405. [PMID: PMID: 12878022] - PubMed
Walls 1988 {published data only}
    1. Walls AWG, Murray JJ, McCabe JF. The management of occlusal caries in permanent molars. A clinical trial comparing a minimal composite restoration with an occlusal amalgam restoration. British Dental Journal 1988;164:288-92. [PMID: PMID: 3164204] - PubMed
Welbury 1990 {published data only}
    1. Welbury RR, Walls AWG, Murray JJ, McCabe JF. The management of occlusal caries in permanent molars. A 5-year clinical trial comparing a minimal composite with an amalgam restoration. British Dental Journal 1990;169:361-6. [PMID: PMID: 2275837] - PubMed
Wilson 1996 {published data only}
    1. Wilson NHF, Wastell DG, Norman RD. Five-year performance of high-copper content amalgam restorations in a multiclinical trial of a posterior composite. Journal of Dentistry 1996;24(3):203-10. [PMID: PMID: 8675791] - PubMed

Additional references

BDA 2013
    1. British Dental Association. The future use of dental amalgam, 2013. Available from www.bda.org/dentists/policy-campaigns/public-health-science/dental-amalg... (accessed 19 March 2014).
CADTH 2018
    1. Canadian Agency for Drugs and Technologies in Health (CADTH). Composite resin versus amalgam for dental restorations: a health technology assessment. Available from www.cadth.ca/sites/default/files/pdf/ht0021_dental_amalgam_report_final.pdf (accessed 19 March 2019). - PubMed
Correa‐Faria 2020
    1. Correa-Faria P, Viana KA, Raggio DP, Hosey MT, Costa LR. Recommended procedures for the management of early childhood caries lesions - a scoping review by the Children Experiencing Dental Anxiety: Collaboration on Research and Education (CEDACORE). BMC Oral Health 2020;20(1):75. - PMC - PubMed
Costa 2012
    1. Costa SM, Martins CC, Bonfim Mde L, Zina LG, Paiva SM, Pordeus IA, et al. A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health 2012;9(10):3540-74. - PMC - PubMed
Cvar 2005
    1. Cvar J, Ryge G. Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clinical Oral Investigations 2005;9(4):215-32. [DOI: 10.1007/s00784-005-0018-z] - DOI - PubMed
Deeks 2017
    1. Deeks JJ, Higgins JP, Altman DG, editor(s) on behalf of the Cochrane Statistical Methods Group. Chapter 9: Analysing data and undertaking meta-analyses. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). Cochrane, 2017. Available from training.cochrane.org/handbook/archive/v5.2.
Dursun 2016
    1. Dursun E, Fron-Chabouis H, Attal JP, Raskin A. Bisphenol A release: survey of the composition of dental composite resins. Open Dentistry Journal 2016;10:446-53. [www.ncbi.nlm.nih.gov/pmc/articles/PMC5039892] - PMC - PubMed
Easterbrook 1991
    1. Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR. Publication bias in clinical research. Lancet 1991;337(8746):867-72. - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-9. [PMID: PMID: 11914310] - PubMed
Espelid 2006
    1. Espelid I, Cairns J, Askildsen JE, Vibeke Q, Gaarden T, Tveit AB. Preferences over dental restorative materials among young patients and dental professionals. European Journal of Oral Sciences 2006;114(1):15-21. [DOI: 10.1111/j.1600-0722.2006.00282] - DOI - PubMed
Ferreira Zandona 2012
    1. Ferreira Zandona A, Santiago E, Eckert GJ, Katz BP, Pereira de Oliveira S, Capin OR, et al. The natural history of dental caries lesions: a 4-year observational study. Journal of Dental Research 2012;91(9):841-6. [CENTRAL: PMCID: PMC3420396] [PMID: PMID: 22821238] - PMC - PubMed
Geier 2011
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant relationship between mercury exposure from dental amalgams and urinary porphyrins: a further assessment of the Casa Pia children's dental amalgam trial. Biometals 2011;24(2):215-24. [PMID: PMID: 21053054] - PubMed
Geier 2012
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A dose-dependent relationship between mercury exposure from dental amalgams and urinary mercury levels: a further assessment of the Casa Pia Children's Dental Amalgam Trial. Human & Experimental Toxicology 2012;31(1):11-7. [PMID: PMID: 21803780] - PubMed
Geier 2013
    1. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers: a further assessment of the Casa Pia children's dental amalgam trial. Human & Experimental Toxicology 2013;32(4):434-40. [PMID: PMID: 22893351] - PubMed
Gomes 2009
    1. Gomes AS, Abegg C, Fachel JM. Relationship between oral clinical conditions and daily performances. Brazilian Oral Research 2009;23(1):76-81. [PMID: PMID: 19488476] - PubMed
Handzel 2017
    1. Handzel S. EU bans dental amalgam use in children, pregnant and breastfeeding women. Available from www.dmdtoday.com/news/eu-bans-dental-amalgam-use-in-children-pregnant-an....
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-60. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Deeks JJ, Altman DG, editor(s). Chapter 16: Special topics in statistics. In: Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Higgins 2017
    1. Higgins JP, Altman DG, Sterne JA, editor(s). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). Cochrane, 2017. Available from training.cochrane.org/handbook/archive/v5.2.
ICDAS 2011
    1. International Caries Detection and Assessment System (ICDAS) Coordinating Committee. Rationale and evidence for the International Caries Detection and Assessment System (ICDAS II). Available from www.icdas.org/downloads (accessed 19 March 2014).
Kelly 2004
    1. Kelly PG, Smales RJ. Long-term cost-effectiveness of single indirect restorations in selected dental practices. British Dental Journal 2004;196(10):639-43. [PMID: PMID: 15153977] - PubMed
Lesaffre 2009
    1. Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Statistics in Medicine 2009;10(28):3470-82. - PubMed
Lutz 1999
    1. Lutz F, Krejci I. Resin composites in the post-amalgam age. Compendium of Continuing Education in Dentistry 1999;20(12):1138-44, 1146, 1148. [PMID: PMID: 10850266] - PubMed
Maserejian 2012
    1. Maserejian NN, Trachtenberg FL, Hauser R, McKinlay S, Shrader P, Tavares M, et al. Dental composite restorations and psychosocial function in children. Pediatrics 2012;130:328-38. [PMID: PMID: 22802599] - PMC - PubMed
Mitchell 2007
    1. Mitchell RJ, Koike M, Okabe T. Posterior amalgam restorations - usage, regulation, and longevity. Dental Clinics of North America 2007;51(3):573-89. [PMID: PMID: 17586144] - PubMed
Mo 2010
    1. Mo S, Bao W, Lai GY, Wang J, Li MY. The microfloral analysis of secondary caries biofilm around Class I and Class II composite and amalgam fillings. BMC Infectious Diseases 2010;10:241. [CENTRAL: PMCID: PMC2931511] [PMID: PMID: 20712908] - PMC - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLOS Medicine 2009;6:e1000097. [DOI: 10.1371/journal.pmed1000097] - DOI - PMC - PubMed
Moraschini 2015
    1. Moraschini V, Fai CK, Alto RM, Dos Santos GO. Amalgam and resin composite longevity of posterior restorations: a systematic review and meta-analysis. Journal of Dentistry 2015;43(9):1043-50. [DOI: 10.1016/j.jdent.2015.06.005] - DOI - PubMed
Nascimento 2010
    1. Nascimento MM, Gordan VV, Qvist V, Litaker MS, Rinda DB, Williams OD, et al. Reasons for placement of restorations on previously unrestored tooth surfaces by dentists in the Dental Practice-Based Research Network. Journal of the American Dental Association 2010;141(4):441-8. [CENTRAL: PMCID: PMC2848821] [PMID: PMID: 20354094] - PMC - PubMed
Paula 2012
    1. Paula JS, Leite IC, Almeida AB, Ambrosano GM, Pereira AC, Mialhe FL. The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life. Health and Quality of Life Outcomes 2012;10:6. [CENTRAL: PMCID: PMC3285522] [PMID: PMID: 22244092] - PMC - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Roulet 1997
    1. Roulet JF. Benefits and disadvantages of tooth-coloured alternatives to amalgam. Journal of Dentistry 1997;25(6):459-73. [PMID: PMID: 9604577] - PubMed
Splieth 2020
    1. Splieth CH, Kanzow P, Wiegand A, Schmoeckel J, Jablonski-Momeni A. How to intervene in the caries process: proximal caries in adolescents and adults - a systematic review and meta-analysis. Clinical Oral Investigations 2020;24(5):1623-36. - PubMed
Tanimoto 2015
    1. Tanimoto Y. Dental materials used for metal-free restorations: recent advances and future challenges. Journal of Prosthodontic Research 2015;59(4):213-5. [DOI: 10.1016/j.jpor.2015.07.003] - DOI - PubMed
UNEP 2013
    1. United Nations Environment Programme. Minamata Convention on Mercury: text and annexes. Available from www.mercuryconvention.org/Portals/11/documents/Booklets/Minamata%20Conve... (accessed 8 March 2017).
UNEP 2016
    1. United Nations Environment Programme. Lessons from countries phasing down dental amalgam use. Available from wedocs.unep.org/bitstream/handle/20.500.11822/11624/Dental.Amalgam.10mar... (accessed 3 April 2018).
UNEP 2017a
    1. United Nations Environment Programme. News release, the 50-ratification milestone required for the Minamata Convention on Mercury to enter into force was reached on 18 May 2017! Available from mercuryconvention.org/News/50ratificationmilestonereachedon18May2017/tab... (accessed 5 June 2017).
UNEP 2017b
    1. United Nations Environment Programme. Minamata Convention on Mercury. Countries: list of signatories and future parties. Available from mercuryconvention.org/Countries/tabid/3428/language/en-US/Default.aspx (accessed 17 February 2021).
WHO 2012
    1. World Health Organization (WHO). What is the burden of oral disease? Available from www.who.int/oral_health/disease_burden/global/en/ (accessed 19 March 2014).
Woods 2013
    1. Woods JS, Heyer NJ, Russo JE, Martin MD, Pillai PB, Farin FM. Modification of neurobehavioral effects of mercury by genetic polymorphisms of metallothionein in children. Neurotoxicology and Teratology 2013;39:36-44. [PMID: PMID: 23827881] - PMC - PubMed

References to other published versions of this review

Lu 2006
    1. Lu H, Koh H, Rasines Alcaraz MG, Schmidlin P, Davis D. Direct composite resin fillings versus amalgam fillings for permanent or adult posterior teeth. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No: CD005620. [DOI: 10.1002/14651858.CD005620.pub2] - DOI - PubMed
Rasines Alcaraz 2014
    1. Rasines Alcaraz MG, Veitz-Keenan A, Sahrmann P, Schmidlin PR, Davis D, Iheozor-Ejiofor Z. Direct composite resin fillings versus amalgam fillings for permanent or adult posterior teeth. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No: CD005620. [DOI: 10.1002/14651858.CD005620.pub2] - DOI - PubMed

Publication types