Effect of bonded amalgam on the fracture resistance of teeth

The purpose of this study was to determine whether amalgam bonded to tooth structure with an adhesive resin cement can increase the fracture resistance of restored teeth. Extracted paired upper premolars were prepared for G.V. Black type mesioocclusodistal amalgam restorations. In one tooth of each pair (the experimental group), the enamel walls were etched with phosphoric acid and were painted with an adhesive resin (Panavia), and amalgam was condensed and carved. For the other tooth in each pair (the control group), amalgam was placed in the same manner but was not etched and lined with resin. The teeth were thermocycled and mounted for testing and then were loaded until fracture. A significant difference (p less than 0.05, the paired Student's t-test) was found in the force needed to fracture the bonded amalgam group (70.5 +/- 21.6 kg) compared with that needed to fracture the conventional amalgam group (60.3 +/- 16.8 kg). SEM examination of fractures at the interface occurred predominantly within the resin.