Amalgam Restorations And The Gold Standard For Restorative Materials

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Amalgam has commonly been used in posterior, stress-bearing restorations and is still considered to be the gold standard for restorative materials, mainly due to its excellent physical properties.1,2 These posterior restorations include complex amalgam restorations, or extensive amalgam restorations, which are commonly defined as restorations in which at least one of the cusps is replaced by amalgam.3,4 Complex amalgam restorations may be considered in the following situations: as an alternative to a crown when the patient cannot afford a crown, or does not have adequate oral health or tooth structure remaining and a crown is contraindicated; as an intermediate restoration prior to a crown; and/or to protect the tooth from fracturing when…show more content…
33% of amalgam restorations were complex in the study by Opdam and others whereas 31% where complex in the study by Forss and Windström.7,9 As shown in the 2003 study by Van Nieuwenhuysen and others, the more extensive the restoration, the more likely fracture is to be the reason for failure rather than secondary caries.5 Given that Opdam and others had proportionally more of the complex amalgam restorations, and Van Nieuwenhuysen and others had only complex restorations included, it is possible that this difference could account for the difference in the relative frequency of the top three reasons for failure. Plasmans and others, however found that the extension of the restoration does not significantly affect the longevity of the restoration.4 Another possible reason for the differences in results is the criteria used for determining if a restoration had failed. Opdam and others let the dentists assessing the restorations decide what would count as a failed restoration, whereas Forss and Windström did not specify the criteria used and Van Nieuwenhuysen and others provided their own criteria.5,7,9 These studies were done in different countries and it is possible therefore, that what one dentist or governing body determines to be a failed restoration is different to what dentist trained in another country determines to be failed. It has

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