Early fracture resistance of amalgapin-retained complex amalgam restorations

Amalgapins are susceptible to early fracture during matrix removal and carving. The purpose of this study was to examine the early fracture resistance of amalgapin-retained restorations using a spherical amalgam alloy, an admixed amalgam alloy, a combination of admixed alloy over the spherical alloy, and a recently introduced modified spherical amalgam alloy. Four amalgapin channels with a diameter of 1.4 mm and depth of 2 mm were prepared in cylinders of Macor, a machinable ceramic material. The amalgapins were hand condensed, and the bulk of the restoration was mechanically condensed. In the group using the combination of alloys, 800 mg of spherical alloy was condensed into the amalgapins and over the floor of the preparation. The admixed alloy was then condensed over the spherical alloy to build up the bulk of the restoration. Using an Instron Universal Testing Machine, the restorations were tested to shear failure at an average of 15.8 +/- 1.3 minutes after the initiation of trituration of the amalgam alloy. A metal ring was placed around the restoration and pulled 90 degrees to the long axis to simulate matrix band removal. Data were analyzed using Kruskal-Wallis procedures. The fracture resistance of the spherical alloy group and the spherical/admixed group were significantly higher than admixed or Tytin FC. All fractures occurred in amalgam at the entrance to the amalgapin channel. The combination of spherical and admixed amalgam alloys in a restoration may reduce the potential for early dislodgment while allowing additional time for carving.