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Dental Materials Restorative Dentistry

Dental Amalgam Update

This summary is based on two critical appraisals published in the Journal of Esthetic and Restorative Dentistry:

Dental Amalgam Update—Part I: Clinical Efficacy (October 2013)

Dental Amalgam Update—Par t II: Biological Effects (December 2013)

Context 

Dental amalgam use has been controversial ever since the Crawcour brothers of France introduced amalgam to the United States in 1833. It has been criticized for its alleged clinical shortcomings and biologic effects.

Dental Amalgam Update—Part I: Clinical Efficacy 

Studies Reviewed

Key Messages

  • Dental amalgam can be bonded to enamel and dentin successfully.
  • Limited studies suggest that preparations for dental amalgam restorations can be similar to those for resin composite restorations in some cases, depending on the clinical conditions encountered.
  • Dental amalgam restorations are associated with lower rates of secondary caries than resin composite restorations.
  • Amalgam restorations are not associated with a high incidence of complete cusp fractures.The incidence of complete cusp fractures is the same with dental amalgam restorations as it is with resin composite restorations.
  • The replacement rate of dental amalgam restorations is more favorable than the replacement rate of posterior resin composite restorations.

Dental Amalgam Update—Par t II: Biological Effects

Studies Reviewed

Key Messages

  • Dental amalgam restorations are not associated with detrimental psychosocial problems in children.
  • Amalgam restorations are not associated with unfavorable neurobehavioral assessments in children.
  • Amalgam restorations have no apparent effect on immune function in children.
  • Amalgam restorations do not appear to affect renal function in children and have no apparent effect on the proportion of children with microalbuminuria.
  • Because of its low replacement rate versus resin-based composite and its apparent safety, dental amalgam restoration should remain a viable treatment option.

 

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3 Comments

  1. Brent Beyak January 7, 2014

    Bravo, clear headed thinking.

    Reply
  2. Al January 21, 2014

    Thank you for the links. Good solid reading material.

    Reply
  3. jlm January 30, 2014

    Extremely glad to see this post. Sadly, a lot of dentists will probably skip over it because they don’t want to be reminded that dental amalgam has a place in modern dentistry. It’s much more convenient to conform to the common practice of denouncing amalgam than it is to support it.

    Reply

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