Bonded amalgams and their use in clinical practice

There has been a move in recent years for operative dentists to use the benefits of adhesive technology when placing dental amalgam restorations. This paper describes the potential advantages of the bonded amalgam technique. These benefits include decreased microleakage between the cavity wall and the restorative material. This, in turn, may decrease post-operative sensitivity, pulpal inflammation and the incidence of recurrent caries. Extra retention for the restoration may also be provided and the need for cavities to rely on traditional retention and resistance form may be decreased or even eliminated, thus conserving precious tooth tissue. If the restoration is bonded then flexure during function in teeth may be decreased and, in the case of teeth exhibiting a cracked cusp, this may alleviate or eliminate symptoms. Bonding may also provide support to weakened tooth tissue which otherwise would have to be removed, so rendering cavities more conservative, and may increase the fracture resistance of the tooth. Clinical examples are included to illustrate some of these benefits.

The use of adhesives to bond amalgam to tooth tissue offers potential advantages, although some of the current evidence is equivocal about their routine use.