A Systematic Review of Amalgam Bonded Restorations: In vitro and Clinical Findings

Area of Science:

• Dental Materials Science
• Restorative Dentistry

Background:

• Amalgam restorations have been widely used, but concerns about tooth structure removal and microleakage persist.
• Bonding amalgam to tooth structure aims to address these limitations.

Purpose of the Study:

• To systematically review the evidence on the physical properties, clinical performance, and implications of bonded amalgam restorations.

Main Methods:

• An electronic literature search was conducted in Medline from 1987 to 2013.
• 170 articles were analyzed for data on bond strength, microleakage, postoperative sensitivity, and longevity.

Main Results:

• High bond strengths were observed with certain adhesive resins and light-cured adhesives.
• Bonded amalgam generally reduced microleakage, particularly when used with dentin bonding agents or resin-modified glass ionomer cements.
• Retention of large restorations was facilitated, but postoperative sensitivity reduction was inconsistent.

Conclusions:

• Bonded amalgam conserves tooth structure and reduces microleakage, making it suitable for large restorations.
• While in vitro bonding enhances retention, consistent clinical evidence across all outcomes is still needed.
• Adhesives offer conservative cavity preparation benefits without compromising retention.