Advanced adhesive restorations: the post-amalgam age

Due to patient demand for biocompatible, safe, and tooth-colored restorations, the use of amalgam as a restorative material has been declining. Currently, the profession of operative dentistry is in a state of transition from the amalgam age to the post-amalgam age. The learning objective of this article is to discuss the current state of the art of tooth-colored restoratives--amalgam substitutes and amalgam alternatives--used either as direct or laboratory fabricated restorations nationally and internationally. Adhesive dentistry is discussed in detail, with tooth preparation as the key element. The challenges facing the clinician during the transition period include clinician education, restorative concepts and teaching competence, costs, prevention, and maintenance.