Restoration of posterior teeth in clinical practice: evidence base for choosing amalgam versus composite

This article reviews the current use of amalgam versus resin composite in posterior restorations and the evidence-base for choosing between these two treatment options. While much research has been published on the issue of the clinical use of amalgam versus resin composite, there are several issues that limit the true evidence-base on the subject. Furthermore, while the majority of published studies on posterior composites would seem to indicate equivalent clinical performance of resin composite to amalgam restorations, the studies that should be weighted much more heavily (randomized controlled trials) do not support the slant of the rest of the literature. As part of an evidence-based approach to private practice, clinicians need to be aware of the levels of evidence in the literature and need to properly inform patients of the true clinical outcomes that are associated with the use of amalgam versus resin composite for posterior restorations, so that patients are themselves making informed decisions about their dental care.