Bonded vs. non-bonded amalgam restorations?
This summary is based on the article published in the British Dental Journal: A comparative study of bonded and non-bonded amalgam restorations in general dental practice (April 2013)
Amalgam has been used to restore teeth since before G. V. Black described the classification of cavities over 100 years ago and is still a first choice material used by most clinicians to restore carious teeth, where aesthetics is not an overriding concern (Berry, Summit, Chung, and Osborne).
A relatively recent development in amalgam restorations has been the introduction of bonded amalgam restorations. The theoretical advantages of bonding amalgam restorations are that (Setcos, Staninec and Wilson):
- Bonding creates an adhesion between amalgam and the tooth surface, reducing or eliminating reliance on macro-mechanical retention and allowing a more conservative cavity preparation without the need for pins.
- Bonding improves natural tooth strength and fracture resistance.
- Bonding creates a better marginal seal, reducing the risk of dentine and pulpal contamination and reduced incidence of secondary caries.
- Bonding reduces postoperative sensitivity.
Purpose of the Study
Compare the performance of non-bonded and bonded amalgam restorations in a general dental practice.
- A retrospective cohort clinical study, including 231 non-bonded amalgam restorations which were compared with 231 bonded amalgam restorations and compared for survival rates and clinical performance.
- Within the limitations of the study, the following conclusions can be drawn:
- Bonded amalgam restorations provided significantly greater longevity than non-bonded amalgam restorations over a five-year period.
- The comparison of postoperative sensitivity rates between the two methods of restoration was inconclusive.
- Bonded amalgam restorations may offer a significant benefit compared to non-bonded amalgam restorations in terms of survival and re-intervention, but this is at the expense of additional clinical time and increased cost.
Berry TG, Summitt JB, Chung AK, Osborne JW. Amalgam at the new millennium. J Am Dent Assoc. 1998;129(11):1547-56.
Setcos JC, Staninec M, Wilson NH. The development of resin-bonding for amalgam restorations. Br Dent J. 1999;186(7):328-32.
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