Hi Eva,

My dentist once gave me a nice ADA brochure comparing all the
available materials. Maybe yours has something like it sitting around
somewhere.

The pros/cons as far as I can tell are like this:
Amalgam
Pro: cheap, requires less skill to do right, long lasting
Con: looks ugly, large filling can expand and crack tooth, can make
tooth temperature sensitive

Composite
Pro: looks nice, unlikely to crack tooth
Cons: shrinks over time allowing decay to recur, requires a more
skilled dentist, expensive, wears more easily

Hi Eva,

My dentist once gave me a nice ADA brochure comparing all the
available materials. Maybe yours has something like it sitting around
somewhere.

The pros/cons as far as I can tell are like this:
Amalgam
Pro: cheap, requires less skill to do right, long lasting
Con: looks ugly, large filling can expand and crack tooth, can make
tooth temperature sensitive

How about minimal removal of tooth structure. ie remove the decay and

Composite
Pro: looks nice, unlikely to crack tooth
Cons: shrinks over time allowing decay to recur, requires a more
skilled dentist, expensive, wears more easily

Hi Eva,

My dentist once gave me a nice ADA

available materials. Maybe yours has something like it sitting around
somewhere.

The pros/cons as far as I can tell are like this:
Amalgam
Pro: cheap, requires less skill to do right, long lasting
Con: looks ugly, large filling can expand and crack tooth, can make
tooth temperature sensitive

Composite
Pro: looks nice, unlikely to crack tooth
Cons: shrinks over time allowing decay to recur, requires a more
skilled dentist, expensive, wears more easily

Now where do you get shrinks over time from????? once the material
cures that's it.
What do you mean allowing decay to recur how does a filling allow
decay to recur???? recurrent decay has nothing to do with the type of
restoration you will find it in patients who do not take good care of
their hygiene and it will happen around any filling composite,
amalgam, porcelain inlay gold crown.
Requires a more knowledgeable dentist in bonding composites. In fact
it takes more hand skills to do the proper preparation for an amalgam
than a composite filling.
With amalgam you are counting on mechanical retention with composite
it is the bond you can achieve.
The newer composites wear same as enamel. If the filling does not wear
at all guess what the opposing tooth does. You will always have some
wear between natural teeth even, the point is to keep it the same
between opposing teeth.

Works for me, but I quit using amalgam in 1985.

:-)
Steve

Now where do you get shrinks over time from????? once the material
cures that's it.
What do you mean allowing decay to recur how does a filling allow
decay to recur???? recurrent decay has nothing to do with the type of
restoration you will find it in patients who do not take good care of
their hygiene and it will happen around any filling composite,
amalgam, porcelain inlay gold crown.
Requires a more knowledgeable dentist in bonding composites. In fact
it takes more hand skills to do the proper preparation for an amalgam
than a composite filling.
With amalgam you are counting on mechanical retention with composite
it is the bond you can achieve.
The newer composites wear same as enamel. If the filling does not wear
at all guess what the opposing tooth does. You will always have some
wear between natural teeth even, the point is to keep it the same
between opposing teeth.

Alexander is right about most things and appears rightly passionate
about composite. The thing I want to add to the discussion is an
interesting anomaly occuring in the research comparing composite and
amalgam.

There are studies that have compared the longevity of composite and
amalgam restorations under tight controls, which usually means that
the group of restorations studied was a limited number done by a few
operators (usually) highly skilled individuals with a good background
in both amalgams and composites in a university or controlled private
practice setting). Most of these studies have concluded that the
longevity of both materials is about the same. So, under optimal
conditions composite is at least as good as amalgam for the posterior
region (and may in fact be better).

However, in most large-scale studies that will study a very large
number of restorations performed by many dentists, amalgam has been
shown to last considerably longer than composite. In a large study of
general practice in Finland for example, average longevity for a
posterior composite was 6 years, whereas a posterior amalgam stayed
around for an average of 11 years.

So, there is a great difference between the optimal conditions
achieved in a research study and the results in your average everyday
practice. Possible reasons for this discrepancy include:
1) Training in many dental schools traditionally focused mainly in
amalgam, so students don't graduate with good composite understanding/
skills and will need to gradually obtain them in postgraduate training
and practice.
2) Amalgam is a very forgiving material, whereas composite will
require very strict placement conditions. This is especially true for
past composite materials, which required a certain amount of clinical
experience to place (some might actually call it "guesswork"),
although things are getting better with newer materials. Obviously, a
more complex placement procedure has a great margin of error.
3) The prevalence of dental disease and economic realities (like
dental insurance) can and will affect treatment quality.

Amalgam is perhaps the best thing that happened to dentistry. Before
amalgam, gold was used for restoring cavities, so restorative
dentistry could only be afforded by the well-off. Amalgam saved
countless of teeth from destruction or extraction and its impact on
modern dentistry cannot be overemphasised. This cheap, reliable
material made restorative dentistry available to the greater public
and without it there probably wouldn't be much interest in developing
new materials, including composites.

A few points that were not mentioned in the discussion: amalgam
generally leaks more than composite, but the silver and mercury salts
it forms are antibacterial and may protect from recurrence.

has a better coefficient of thermal expansion than composite.

Regards,
George

Works for me, but I quit using amalgam in 1985.

:-)
Steve


My dentist used amalgam in 1992 (as close to a year as poosible after
bila

Interesting responses. I must say that one of the fillings that has
to be redone is a composite filling from around 1992. Sure didn't
last long. I have two amalgam fillings in numbers 14 and 15 that were
done 45 years ago, and they are still intact. There is no decay
around those old amalgam fillings. They have held up better than the
one composite filling I do have.

Eva

Miles Markley, anyone?