Radiopacities in dentine under amalgam restorations

Radiopacities, caused by tin or zinc deposits in partly demineralized dental tissue, are frequently seen under amalgam restorations. The aim of this study was to determine to what extent these radiopaque areas could be identified by Caries Detector (1% acid red in propylene glycol) which is claimed to stain the irreversibly demineralized dentine. Twenty-eight extracted teeth showing radiopacities under amalgam fillings were selected. The restorations were removed, and Caries Detector was applied. Caries was excavated until the dentine did no longer stain with the Caries Detector. Standardized radiographs were taken at different stages. In all teeth the radiopaque areas stained with the Caries Detector. Visual inspection of the radiographs, taken after excavation, revealed that the radiopacities had disappeared completely in 6 teeth; in 5 teeth a very small part of the radiopaque area remained; in 17 teeth the cavity floor appeared as a thin white line on X-ray. Overall, line scan analysis confirmed the data obtained by visual observation. The residual radiopacities and radiopaque lines were a very small fraction of the initial radiopacities. Therefore, it is concluded that the radiopaque zone under amalgam fillings represents almost entirely an area of irreversibly demineralized dentine as indicated by the Caries Detector.