Effect of restoration size on fracture resistance of bonded amalgam restorations

The purpose of this study was to determine the effect of restoration size on the fracture strength of amalgam restorations bonded with Amalgambond Plus (with HPA). Research has shown that this adhesive is dispersed throughout the unset amalgam during condensation and that a decrease in diametral tensile strength, proportional to the amount of adhesive incorporated into the unset amalgam, has resulted. Smaller cavity preparations have a higher ratio of surface area to volume than do larger preparations, and it was anticipated that a proportionately greater amount of adhesive would be incorporated into smaller amalgam restorations. Sixty extracted human molars were divided into four groups of 15 teeth and mounted in tray acrylic-filled PVC cylinders. Shallow approximo-occlusal channels were prepared in two groups. One group was restored with Amalgambond Plus and Tytin amalgam, the other with just Tytin amalgam. Larger proximo-occlusal preparations were made in the remaining two groups, then restored in the same fashion. Samples were stored in 37 degrees C for at least 24 hours, then thermocycled from 5-55 degrees C 1000 times with a one-minute dwell time. Specimens were mounted in a Universal Testing Machine, and a chisel was applied to the restorations in compression mode at a crosshead speed of 5.0 mm/minute until bulk fracture of the amalgam occurred. The results indicated no difference in bulk fracture strengths between large amalgam restorations restored with and without Amalgambond Plus. However, small amalgam restorations restored with Amalgambond Plus exhibited significantly greater (p < 0.025) bulk fracture strengths than small amalgam restorations restored without use of the adhesive.