Early prediction of long-term margin adaptation of dental amalgam restorations

The present study assessed the predictive value of an indirect metric method for the early detection of margin defects of amalgam restorations, relative to results using a direct clinical method. The material consisted of plaster casts of amalgam restorations taken at 1- and 2-yr examinations of four different amalgam-treatment combinations. The widest margin defect of each restoration was measured in a dissection microscope equipped with a metric scale in the ocular. The ranking order obtained from the metric measurements of the different amalgam-treatment combinations after 1 and 2 yr was compared with that obtained from the direct clinical evaluation after 2 yr. Finally, the rank order of those restorations rated Alfa (no visible evidence, along the margin, of a crevice (ditch) into which an explorer will penetrate) at the 2-yr clinical examination was studied in relation to the 1-yr metric measurements. For the total material, the rank order based on the metric measurements of the margin defects of the four amalgam-treatment combinations agreed with that obtained with the clinical rating. In the 1-yr data, where the metric technique was applied only on the restorations rated Alfa at the 2-yr clinical evaluation, the order of two neighboring combinations was reversed; otherwise the same rank order was obtained. It is recommended that the clinical performance of new brands of amalgam alloy are tested in short-term, small-scale studies using the metric evaluation technique, before more extensive field studies over longer periods are instituted, in order to sort out unsatisfactory materials and treatment techniques at an early stage.