No evidence that bonding is needed for amalgam restorations

Area of Science:

• Dental Materials Science
• Restorative Dentistry
• Clinical Trials Research

Background:

• Amalgam remains a common dental restorative material.
• Adhesive bonding techniques are sometimes used with amalgam restorations.
• The clinical benefit of adhesive bonding for amalgam is not well-established.

Purpose of the Study:

• To evaluate the survival rates of adhesively bonded versus non-bonded amalgam restorations.
• To compare post-insertion sensitivity and marginal adaptation between the two techniques.

Main Methods:

• Systematic search of multiple databases for randomized controlled trials.
• Inclusion of trials comparing bonded and non-bonded Class I and II amalgam restorations in permanent molars and premolars.
• Independent data extraction and synthesis by two reviewers.

Main Results:

• One trial with 113 restorations (31 patients) was included.
• At two years, survival rates were high for both groups, with no statistically significant difference.
• No significant differences were reported in post-insertion sensitivity, fractures, or marginal adaptation.

Conclusions:

• There is insufficient evidence to support or refute a survival difference between bonded and non-bonded amalgam restorations.
• The additional benefits of adhesive bonding for amalgam restorations are not demonstrated.
• Clinicians should consider the potential increased costs associated with adhesive bonding.