Amalgam bonding: visualization and clinical implications of adhesive displacement during amalgam condensation

Resin adhesive was visualized in this in vitro study of amalgam bonding using methylene blue dye incorporated into the resin or by scanning electron microscopy. Class II amalgam cavities were prepared in extracted teeth previously stored in buffered formalin. The preparations were then restored following manufacturers' instructions, but included methylene blue dissolved in ethanol into the adhesive resin mixture. This procedure had little effect on the setting time of the resin. Following condensation and carving, excess resin was incorporated into the body of the restorations as well as onto all adjacent coronal surfaces with significant occlusal and proximal accumulations. Resin also accumulated in significant amounts on the gingival floor of the proximal box and at line angles and retentive grooves within the preparation. In conclusion, radiological studies demonstrated that artifacts produced by resin accumulation at the gingival floor of the box could be mistaken for an open margin or recurrent caries. Other potential clinical consequences of resin residue on tooth surfaces are discussed, including the problem of interproximal ledges and occlusal discrepancies. The incorporation of a radiopaque material in the resin systems should be a universal requirement.