Amalgam marginal quality assessment: a comparison of seven methods

Black's class I classic cavities were cut in 120 sound extracted human premolars and restored with one of two silver amalgams, six different base combinations, with or without cavity varnish and then aged for 3 months or 1 year. Thereafter, the restored teeth were subjected to a bacterial or acid broth in vitro carious challenge for 36 days. Resin cast impressions were made of the restoration margin of each specimen before and after the carious challenge giving a total of 240 replicas. The replicas were examined in a scanning electron microscope (SEM) and the margins subjected to seven marginal assessment procedures: (i) ranking using micrographs of the margin; (ii) percentage length of marginal discrepancy; (iii) Mjor assessment using six groups; (iv) number of margin segments showing a discrepancy; (v) greatest gap size; (vi) ranking based firstly on gap size and then number of margin segments showing a discrepancy; and (vii) ranking based firstly on gap size and then percentage length of marginal discrepancy. The data from procedures (i), (ii), (vi) and (vii) were examined using one-way ANOVA; a linear logistic statistical analysis examined data from procedures (iii)-(v). Statistical significance was chosen at P < 0.05. It was found that procedure (vii) was able to discriminate between variables to a greater degree than all other procedures. It is recommended that a ranking system based on greatest gap size and percentage length of marginal discrepancy be used to assess marginal quality of amalgam restorations.