Dental amalgam

by Kazhan Omer Abdulrahman

 Amalgam—An alloy containing mercury.

 Dental amalgam—An alloy that is formed by reacting

mercury with silver, copper, and tin, and which may
also contain palladium, zinc, and other elements to
improve handling characteristics and clinical
performance.

 Dental amalgam alloy (alloy for dental

amalgam)—An alloy of silver, copper, tin, and other
elements that is processed in the form of powder
particles or as a compressed pellet.
amalgam alloys

irregularly as as a
shaped spherical mixture of
particles both lathe-
cut and
spherical
particles
composition of amalgam alloy:

 Low-Copper Alloys
Silver-tin alloys are quite brittle and difficult to blend
uniformly unless a small amount of copper is
substituted for silver. Within the limited range of
copper solubility, an increased copper content hardens
and strengthens the silver tin alloy.
High-Copper Alloys

 The first high-copper alloy

This modification raises the copper content to 11.8%
by weight. This is often called “dispersed-phase alloy”
or “admixed high-copper alloy.”
 A second type of high-copper alloy
This process yields a single composition system. The
copper content of this group of alloys can be as
high as 30% by weight.
Gallium-Based Alloys

In an attempt to eliminate mercury from direct

metallic restorative materials.
gallium , has been considered as a substitute
which is also a liquid when alloyed with indium
and tin at room temperature. Like mercury, this
metal element can be triturated with alloys for
high-copper amalgam.
POWDER CONFIGURATION

 the physical configuration and condition of the

particles will have a significant influence on the
setting process.
Lathe-Cut Powder versus Spherical
Powder
 Amalgams made from lathe-cut powders or admixed
powders tend to resist condensation better than
amalgams made entirely from spherical
powders.(why?)

 Spherical alloys require less mercury than typical

lathe-cut alloys(why?)
Particle Size
 Smaller particles greatly increase the surface area per
unit volume of the powder. A powder containing tiny
particles requires a greater amount of mercury to form
an acceptable amalgam.
 During carving, the larger particles may be pulled out
of the matrix, producing a rough surface. Such a
surface is probably more susceptible to corrosion than
a smooth surface. A smaller average particle size tends
to produce a more rapid hardening of the amalgam
with greater early strength.
 The physical properties of the hardened amalgam depend on
the relative percentages of each of the micro structural
phases.

 The greater the number of unconsumed Ag-Sn particles

retained in the final structure, the stronger the amalgam will
be.

 The γ2 phase is the weakest and least stable in a corrosive

environment and may suffer corrosion attack especially in
crevices of the restorations.

 the addition of more than 6% of copper by weight can

reduce or eliminate the γ2 phase by formation of the Cu-Sn
phase.
Clinical manipulation of amalgam
for restorations

 The amount of alloy and mercury to be used can be

described as the mercury/alloy ratio.

 The mercury content of the lathe-cut alloy is about

50% by weight and that for spherical alloys is 42% by
weight.
Triturators

 A triturator should be used at the speed recommended

by the alloy manufacturer.

 For a given alloy and mercury/ alloy ratio, increased

trituration time and/or speed shorten the working and
setting times.
 appears rounded with a smooth shiny surface ,
the strength will be optimal and the smooth
carved surface will retain its luster long after
polishing.

has low strength and poor resistance to corrosion.

the rough surface left after carving of the
granular amalgam will increase its susceptibility
to tarnish ,The mixture may appear in solid mass,
but the surface remains without luster as shown.

is shinier than that of the properly triturated one,

and because of more fluid consistency the mass
appears flattened by the force of trituration.
 Condensation
 The goal of condensation is to compact the alloy into the
prepared cavity so that the greatest possible density is
attained, This results from a reduction of excess mercury and
porosity within the set amalgam.

 The field of operation must be kept absolutely dry during

condensation.

 Sufficient pressure should be used to remove voids and to

adapt the material to the walls.

 The longer the time that elapses between mixing and

condensation, the weaker the amalgam will be(why?)
Carving and finishing

 The objective of carving is to simulate the anatomy

rather than to reproduce extremely fine
details.(why?)

 Carving should not be started until the amalgam is

hard enough to offer resistance to the carving
instrument. (why? )
 PROPERTIES OF AMALGAM
1-dimensional stability
 Amalgam can expand or contract, depending on its
manipulation.

 Severe contraction can lead to microleakage , plaque

accumulation, and secondary caries.

 Excessive expansion can produce pressure on the pulp and

postoperative sensitivity. Protrusion of a filling can also result
from excessive expansion.
 expansion will occur if sufficient mercury is present in the
mix.

 manipulation with less mercury in the mix, as occurs for

lower mercury/alloy ratios and higher condensation
pressures, will favor contraction. In addition, manipulative
procedures that accelerate setting and consumption of
mercury also favor contraction, including longer trituration
times and use of smaller alloy particles.
 What is delayed expansion or secondary
expansion?

 When a zinc-containing, low-copper or high-copper

amalgam is contaminated by moisture during
trituration or condensation, a large expansion can take
place. This expansion usually starts 3 to 5 days after
placement and may continue for months, reaching
values greater than 400 μm/cm (4%) .
2-strength

 The strength of amalgam is more than adequate

under compressive loads. However, amalgam is
much weaker in tension than in compression.

 More common are defects at the margins of

amalgams.
 Trituration

Amalgam
Mercury
Hardening
Rate Content
factors
affecting
amalgam
strength :

Porosity Condensation
 3-creep
 occurs when a solid material slowly deforms plastically
under the influence of stresses.

 Creep rate has been found to correlate with marginal

breakdown of conventional low-copper amalgams;
that is, the higher the amount of creep, the greater is
the degree of marginal deterioration.
 4-tarnish and corrosion resistance
 tendency toward tarnish, does not affect or hange the
mechanical properties of the amalgam.
 Corrosion, on the other hand, has a negative effect on the
properties.
 Every effort should be made to produce a smooth,
homogeneous surface on a restoration in order to
minimize tarnish and corrosion.
 Whenever a gold restoration is placed in contact with an
amalgam, corrosion of the amalgam can be expected as a
result of the large differences in electromotive force
(EMF) of the two materials. The corrosion process can
liberate free mercury, which can contaminate and weaken
the gold restoration. Biological effects such as galvanism
can also result.
 Clinical performance of amalgam
restorations
 Amalgam does not adhere to the tooth structure. At best it
affords only a reasonably close adaptation to the walls of the
prepared cavity. For this reason cavity varnishes are used to
reduce the gross leakage that occurs around a new filling.

 The use of dentin bonding agents with amalgam is another

relatively new method to reduce microleakage.

 If the amalgam is properly inserted, leakage decreases as the

restoration ages in the mouth.(how?)
 marginal breakdown
 Although the ditching of a margin may not have progressed
to the point where secondary caries may have developed, the
restoration is unsightly and further deterioration may be
anticipated.
Survival of amalgam restorations
 The median survival times for posterior amalgam
restorations were 7 to 15 years in general practices. Larger,
more complex restorations fall within the lower range.
 Repaired amalgam restorations
 The important factor related to the quality of the amalgam
repair is the interfacial bond between the new and the
existing amalgam.

 The surface of an old amalgam to be bonded should be

roughened to remove corrosion and saliva contaminants and
freed of loose debris.

 When a freshly triturated amalgam is condensed directly

onto the roughened surface of an existing amalgam, the
flexural strength of the repaired structure can reach 50% of
that of unrepaired amalgam.
 Making a slot on the existing amalgam to establish
mechanical interlocking between the two materials also
improves the quality of the repair joint.

 Another repair option for areas that exhibit minor marginal

breakdown—gaps that are 250 μm or less in width—is to etch
the enamel adjacent to the restoration and, after rinsing and
drying the marginal gap area, sealing the gap with a dentin
bonding adhesive.

 When secondary caries is diagnosed, it inevitably requires

the replacement of the restoration, but an alternative
treatment is to remove part of the restoration to the full
depth at the site of the defect.
 The repair should be attempted only if the area
involved is one that will not be subjected to high
stresses or one in which the two restoration parts
are adequately supported and retained.
 Safety of amalgam fillings

Toxicity
total amount of mercury vapor
released during occluding on
amalgam restorations is far
below the “no effect” level
Allergy
are experienced by less than
1% of the treated population
 Mercury hygiene in dental offices
 The operatory should be well ventilated.
 All excess should be collected and stored in well-sealed
containers.
 Proper disposal through reputable dental vendors is
mandatory to prevent environment pollution.
 The use of an ultrasonic amalgam condenser is not
recommended.
 Instruments can be used that yield a time-weighted average
for mercury exposure to sample the air in the operatory.
 Film badges are also available that can be worn by office
personnel in a manner similar to radiation exposure badges.
 Biological determinations can be performed on office staff to
measure mercury levels in blood or urine.
Thanks for your attention