Repair of amalgam restorations with composite resin and bonded amalgam: a microleakage study

Total replacement is the most common technique for defective amalgam restorations, and it represents a major part of restorative dental treatment. Repair is an alternative option for amalgam restorations with localized defects.

This study compared microleakage of amalgam restorations repaired by bonded amalgam or composite resin.

Thirty extracted human pre-molars were prepared and restored with class I amalgam. A simulated defect was prepared that included the cavosurface margin on restorations, and the pre-molars were assigned to two treatment groups (n=15): In group 1, premolars were treated by composite resin (34% Tooth Conditioner Gel + Adper Single Bond 2 + Z100) and in group 2, premolars were repaired by bonded amalgam (34% Tooth Conditioner Gel + Prime and Bond 2.1 + Permite C). The teeth were immersed in a 50% silver nitrate solution, thermocycled, sectioned longitudinally and then observed by three examiners using a stereomicroscope. Microleakage was evaluated using a 0-4 scale for dye penetration, and data was analyzed by Kruskal Wallis and Dunn tests.

Neither of the two methods eliminated microleakage completely. Composite resin was significantly the most effective for repair/tooth interface sealing (score 0 = 80.0%; P=0.0317). For the repair/restoration interface, composite resin was also statistically more effective as a sealant (score 0=66%; P=0.0005) when compared to the bonded amalgam technique (score 0=13%; P=0.0005).

The use of adhesive systems significantly affected the ability to seal the repair/ tooth interface. However, at the level of the repair/restoration interface, the bonded amalgam technique may increase microleakage.