Biocompatibility of Amalgam vs Composite - A Review

The Minamata Convention resulted in restrictions in the use of amalgam in daily dental practice. This opens up new discussions about the biocompatibility of amalgam, but also of composites as alternative materials. In the following review article, these issues will be discussed in more detail to provide dentists with a knowledge base for themselves and for communication with their patients. In addition to mercury in amalgam or monomers in composites, bisphenol A and nanoparticles generated during the grinding, polishing or removal of restorations must also be included in the biocompatibility evaluation. In laboratory tests, these substances cause toxic reactions, and bisphenol A also exhibits estrogen-like effects. However, it must be taken into account that the concentrations used in laboratory tests are much higher than in clinical practice. Thus, both amalgam and composite can be used in the general population. Nevertheless, for scientifically, politically and legally defined risk groups (e.g. dental personnel, allergic persons, pregnant or lactating women, children under 15 years of age, people with certain systemic diseases), indication restrictions and precautionary measures must be observed. The well-known amalgam discussion has taught us the importance of thorough and open risk communication with the patient.