Class I Amalgam Restoration

Armamentarium:
Rubber dam
Amalgam alloy
Instruments:
-Mirror -Amalgam carrier
-Explorer -Amalgam condensers
-Cotton pliers -Amalgam carvers
-Amalgam well -Amalgam burnishers

Procedure:
Clean and dry the preparation.
Select the amount of the alloy you need. Triturate the capsule (one at a time); convey
the mix into an amalgam well. A properly triturated amalgam appears homogeneous
and is in a shiny plastic state. It should not be dry or crumbly.

Properly triturated amalgam

Use an amalgam carrier to transfer amalgam from the amalgam well into the cavity
preparation. To fill the carrier, hold the carrier with open forefinger and press it into
the amalgam mass; repeat this procedure several times to pack amalgam into the
carrier.
Place the loaded carrier on the preparation and keeping the nozzle of the carrier in
contact with the tooth structure, express the amalgam. Start by placing the first load
into the narrowest and hardest to reach area.

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 Loading the Amalgam Carrier Expressing Amalgam into
Cavity Preparation

Use the small end of the condenser (IP) to condense the amalgam with an overlapping
stepping movement over the pulpal floor and into the pulpal line angles Be sure to
apply adequate pressure. The direction of the force should be perpendicular to the
walls of the preparation. Start with the smaller condenser while filling the preparation
and then change to a larger one for over packing.

Condensing Amalgam
into Cavity Preparation

Load another increment of amalgam, carry it to the preparation and condense it within
the cavity preparation. Each condensed increment should fill around one-third of the
cavity depth.

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 This procedure should be repeated until the preparation is overfilled by 1.0 mm or
more to ensure that the cavosurface margins are completely covered with well-
condensed amalgam.

Overfilling the Cavity Preparation to

ensure complete coverage of all
cavosurface margins.

The working time, from trituration until the cavity is over-filled, is between 3-3.5
minutes. If the preparation is not filled within this time, a new mix is required.
Pre-carve burnishing: This is a form of condensation. The over packed amalgam
should be burnished with the ball burnisher (large side) using heavy strokes mesio-
distally and facio-lingually. The acorn burnisher can be used with light pressure in the
central groove to begin developing anatomy.

Using the Acorn Burnisher for

Pre-carve Burnishing.

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 Carving: Carve the margins to reduce the excess amalgam beyond the cavosurface
margin with the Hollenbeck carver or the small discoidcleoid carver. Always carve
the amalgam from the tooth toward amalgam. The edge of the instrument is moved
parallel to the cavosurface margin. Part of the instrument should rest on the
unprepared tooth surface and the other part on the amalgam in order to avoid ditching
of the margins during carving.

Carving the Amalgam using the

Hollenbeck Carver.

The restoration should reproduce the normal anatomical and functional form of the
tooth and restore major anatomical features of the original tooth: major grooves and
pits should replicate the original depth, the marginal ridges are of appropriate height,
and cuspal inclines are correct.
Deep occlusal carving should be avoided as it weakens the restoration and can lead to
fracturing of the thinned amalgam.
Under carving should be avoided as well; it leaves a thin portion of the amalgam on
the tooth surface, which can cause the patient to contact prematurely. The restoration
will feel high and the margin will break away.
Post-carve burnishing: this is light rubbing of the carved surface with a burnisher to
improve marginal adaptation and smooth the surface. Post-carve burnishing should be
done soon after the initial carving and not after the amalgam has completely
hardened.

Post-carve Burnishing

Smooth the carved amalgam surface with a wet cotton pellet.

Evaluate the restoration to make sure that you do not have open, plus, or sub margins.

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 Submarginal Area:
Explorer tip catches from
restoration to tooth.

Plus Margin: Open Margin:

Explorer tip catches from Explorer tip catches both
tooth to restoration. ways.

Occlusion should be checked after removing the rubber dam.

The restoration can be polished after 24 hours.
Surplus amalgam and used amalgam capsules are considered biohazardous waste.
Discard the excess amalgam in special containers, which are available in the Sim-
clinic. DO NOT discard it in the trash or down the drain.

Carved Amalgam Restoration

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 Class I Amalgam Restoration
Criteria for Evaluation

Tooth #-----------

1. Occlusal surface

Correct contour of cuspal inclines; They follow 2 1 0

adjacent tooth structur.e

Well condensed, no pits or voids. 2 1 0

Well defined central grooves and fossae. 2 1 0

Marginal integrity: restoration is flush with 2 1 0

cavosurface margins, no excess or deficiencies.

Correct occlusion. 2 1 0

Total points: _________

Maximum possible points: 10
Passing points: 7

Grade of 2: Very good, follows the criteria.

Grade of 1: Slight variation from the criteria.
Grade of 0: Unsatisfactory, lacking the criteria.

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