DENTAL AMALGAM

Rutika Pathrabe
Roll no. 97
CLASSIFICATION
According to the number of alloy metals

1. Binary alloys (Silver-Tin)

2.Ternary alloys (Silver-Tin- Copper)
3. Quaternary alloys (Silver-Tin-Copper-Indium)
According to powder particle size

1. Micro cut
2. Fine cut
3. Coarse cut
According to the Copper content.

1. Low copper alloys (<6% copper)

2. High copper alloys (>6% copper)

- Single composition alloy
-Admixed alloy
According to presence of Zinc

1. Zinc containing (alloy containing >0.01% Zn)

2. Non zinc containing ( alloy containing

<0.01%Zn)
Based on Gamma2( Y2) content

Amalgams maybe described as Y2 containing and

Y2 free.

Low copper amalgams contain the Sn-Hg phase,

which is called Y2 phase to distinguish it from the
Y phases of the Ag-Sn and Ag-Hg alloy systems.

Within several hours after amalgamation, all

correctly manipulated high copper amalgams are
Y2 free
According to the shape of the powdered
particles.

1. Spherical shape (Smooth surfaced spheres)

2. Lathe cut (Alloy particles are irregular in
shape)
3.Admixed (Combination of lathe cut and
spherical alloy)
DIFFERENCES BETWEEN LATHECU
T & SPHERICAL ALLOYS
 COMPOSITION
Conventional or low copper alloys
High Copper Amalgam Alloys
◾ ADMIXED ALLOYS
-Also called as blended alloys
- Contains 2 part weight of conventional lathe
cut and 1 part weight of sphere of a silver
Copper eutectic alloy.

◾ SINGLE COMPOSITION ALLOY

- Also called as unicomposition alloy
- Contains particles of single composition
- Usually spherical single composition alloys are
used.
Silver - Increases setting expansion and strength
Decreases creep

Tin - Slows down setting reaction

Helps in amalgamation

Copper - Increases strength, hardness and setting

expansion

Zinc - Minimizes oxidation

Palladium - increases hardness and whitens the alloy

AMALGAMATION REACTION
INITIAL REACTION -
Similar in all alloys

- Mercury (Hg) dissolves silver (Ag) and tin (Sn) from

alloy
- Dissolution alloy particles and precipitation of
new alloy
FINAL REACTION In Low Copper / Conventional alloy

Intermetallic compounds are formed - these vary

according to the composition of alloy
FINAL REACTION In Admixed High Copper Alloys

Step 1-

Four phases are formed

*Gamma
*Gamma1
*Gamma2
*Unreacted silver copper
alloy
Step 2 -

- Gamma 2 reacts with copper from the silver-

copper alloy, to form copper tin phase
- Thus, gamma 2 phase
is substantially reduced
PROPERTIES OF AMALGAM

Strength
Creep
Corrosion
Dimensional changes
• Compressive strength

– Resistance to compression forces is the most favorable

strength characteristic of amalgam.
– The high-copper unicompositional materials have the
highest early-compressive strengths of more than 250
Mpa at 1 hour.
– The minimum required compressive strength is 310 Mpa.
– High values for early-compressive strength are an
advantage for an amalgam, because they reduce the
possibility of fracture by prematurely high contact
stresses from the patient before the final strength is
reached
• Tensile strength

– Tensile strengths are only a fraction of their

compressive strengths; therefore cavity designs
should be constructed to reduce tensile stresses
resulting from biting forces.
- Amalgam is weaker in tensile strength,
55-62 Mpa
Creep

Defined as a time dependent plastic deformation

produced by stress.
According to ADA specification no. 1, creep should be
below 3%

For High copper amalgam, the creep rate are less

(<0.1%)

Clinically creep lead to protrusion of restoration,

making the amalgam more prone to fracture,
overhangs
Corrosion

Low copper amalgam has much lower resistance

to tarnish and corrosion as compared to high
copper amalgam due to the formation of gamma 2
phase (Sn-Hg phase), which has least resistance to
corrosion.

It has been found that phosphate buffer solutions

inhibit the corrosion process, hence it can be said
that saliva may provide some protection to dental
amalgam from corrosion.
Dimensional Changes

When mercury is combined with amalgam,

it undergoes 3 distinct dimensional changes
Stage 1 - Initial contraction.
Occurs for 20 minutes after beginning of
trituration.
Contraction results as the alloy particles dissolve in
mercury.

Stage 2 - Expansion
Occurs due to formation and growth of crystal
matrix around the unconsumed alloy particles.

Stage 3 - Limited delayed contraction

INDICATION OF AMALGAM

• Moderate-to-large restorations
• Restorations that are not in highly esthetic
areas of the mouth
• Restorations that have heavy occlusal contacts
• Restorations that cannot be well isolated
• Restorations that extend onto the root surface
• Foundations
• Abutment teeth for a removable partial denture
• Temporary or caries control restorations.
CONTRAINDICATION OF AMALGAM

• Esthetically prominent areas of posterior teeth

• Small-to-moderate classes I and II restorations
that can be well isolated
• Small class VI restoration
Advantages

▪Sealing ability improves with age by

formation of corrosion products at tooth
amalgam interface.
▪Relatively less technique sensitive
▪Decrease marginal leakage
▪Prolonged life of restoration.
Disadvantages

▪Non esthetic
▪Increase chances of tarnish and corrosion
▪Metallic taste and galvanic action
▪Lack of chemical bonding with the tooth
structure
▪Delayed expansion
Selection of alloy

Rate of hardening, smoothness of the mix, and ease of

condensation and finishing vary with the alloy.

1) High copper alloy - when significantly more copper is

available, improved laboratory properties and clinical
performance have been demonstrated.

Advantages- Have low creep. Creep is the tendency of a

material to deform continously under a constant applied
stress , marginal breakdown.

2)Zinc free, high copper alloy should be used when the

dentist operates in field where moisture control is difficult
• Alloy and mercury are mixed by hand with a
mortar and pestle or in an amalgamator. This
process is called
trituration.

The objective of trituration is to completely wet

the entire surface of alloy particles with mercury
to bring about the process known as
amalgamation.
Amalgamators are made to work at different
speeds and the action should be checked
periodically.
The efficiency can be tested with a trial mix.
The freshly mixed mass is dropped on to the bench
from a height of approximately 30cm.
If the mix is dry and crumbles, trituration time should
be increased.
A well mixed amalgam should stay together when
dropped on the bench, but should be a little flattened
and retain a wet gloss on the surface
It is better to slightly overtriturate than to
undertriturate amalgam because greatly extended
trituration may reduce plasticity, shorten working
time and increase final contraction
• The next step in amalgamation is mulling,
which is rubbing of the mixture to remove excess
mercury and give a cohesive form. This is done
by squeezing the mixture with a muslin cloth to
drain out the extra mercury

• As the mercury disappears the amalgam

hardens and is
ready for condensation in the cavity.
Condensation refers to
Incremental placement of amalgam into the
prepared cavity and compresssion of each
increment into the next to form a continous
homogenous mas that is well adapted to all the
margins, walls and line angles.
It is best carried out using hand instrument with a
smooth flat face that can deliver reasonable force
per unit area to amalgam and compress the layers
together
Mechanical condensers are available and reduce
the need for application of load.
However there is an undesirable generation of heat
and mercury vapour.
Ultrasonic condensation has been suggested, but it
is not recommended because it allows the release
of considerable quantities of mercury vapour in the
atmosphere with a consequent risk to the
operators
After trituration amalgam should be condensed
into the cavity within 4 minutes.

Next step is trimming and carving.

Carving should be started when restoration is hard
enough to offer resistance to instrument
Scraping sound should be heard.
Burnishing

Restoration to be smoothened with the help of ball

burnisher.
Very light pressure should be applied .
Burnishing stroke starts at amalgam surface and goes
upto tooth surface.

Polishing
To remove scratches
Should be done 24 hrs after condensation
Structure of set amalgam

Eame's technique-
According to this technique, alloy and mercury are
used in the ratio of 1:1

Provided minimal amount of mercury is used,

commensurate with complete amalgamation and
proper condensation techniques, approximately 35-
50% of the final volume of the set amalgam will
consist of unreacted portions of alloy particles held
together by the gamma phase matrix
Moisture Contamination
It is essential to keep the amalgam completely free
from moisture contamination during the entire
placement procedures following trituration.
The cavity must be completely dry and free of
gingival seepage or haemorrhage.
Inclusion of water will lead to increase in corrosion
and tarnish with a reduction of physical properties.
A zinc containing amalgam will develop a delayed
expansion.
Marginal Sealing and Bonding

Newly placed amalgam is subjected to degree of

microleakage, which is undesirable.

There are 2 alternatives available for this.

1. Copal Varnish
2. Resin bond
Copal varnish

This has been used for many years and provides

an immediate seal that will last for a limited time
only.
It is recommended that it should be in two
applications of very thin coat.
Resin Bond

There has been a move lately to replace the copal

varnish with an unfilled resin bond such as those
used as an enamel bonding agent with composite
resin.
The theory behind this is that the resin bond will
develop some degree of union with enamel and
dentin on one side and amalgam on the other
side and thereby both seal the margin as well as
strengthen the tooth crown and compensate to
some degree for the destruction caused by cavity
preparation.
A bond with very low viscosity should be used
and placed carefully in a single layer, taking
care to not allow it to puddle in the corners, it
should then be light activated before placing
the amalgam so that it will not be
incorporated in the amalgam during
condensation.
MERCURY TOXICITY
• The initiation of toxic effects of mercury
was first evaluated in fishermen when they
contacted Minamata disease due
to excess mercury in water.
• Mercury penetrates from the restoration
into tooth structure.
An analysis of dentin underlying amalgam
restorations reveals the presence of mercury, which
in part may account for a subsequent discoloration
of the tooth. Use of
radioactive active mercury in silver amalgam has
also revealed that
some mercury might even reach the pulp.
• The maximum level of occupational exposure
considered safe is 50 µg of mercury per cubic
meter of air per day.
• Amalgam tattoo is a common pitfall of the
amalgam restoration.
Operatory prevention

• The operatory should be well ventilated.

• All excess mercury, including waste, disposable
capsules,
and amalgam removed during condensation should
be
collected and stored in well sealed containers
containing
water.
• Proper disposal through reputable dental
vendors is
mandatory to prevent environmental pollution.
• Amalgam scrap and materials contaminated
with mercury
or amalgam should not be incinerated or
subjected to heat sterilization.
• If mercury comes in contact with the skin,
the skin should be washed with soap and water.
• Use of carpeting is limited as it may
incorporate mercury
vapors and waste.
ADVANCEMENTS
Bonded Amalgam
During the 1990's some clinicians began to routinely
bond amalgam restoration to enamel and dentin.
After preparation of the cavity, enamel and dentin,
etched using a conventional etchant, a chemically cured
resin bonded agent applied to the walls of the cavity.
Amalgam is condensed on the unset adhesive resin liner
that leads to mechanical interlocking.
Adhesive resin adheres to amalgam roughness,
micromechanically forming a rigid physical bond. While
with dentin it forms a hybrid layer
▪Bonded amalgams conserve more tooth structure by
reducing the need to remove sound tooth tissue for
mechanical retention.
▪Increased amalgam retention
▪Reduce marginal leakage
▪Potentially reduce sensitivity
▪Improve fracture resistance
Disadvantages of bonded amalgam -

▪Clinical difficulty of application of more viscous

bonding agents
▪Lightly filled resin bonding agents tend to pool at
the gingival margins resulting in a higher potential
for microleakage
▪Carving is difficult
▪Requires practitioner to adapt to new technique
▪Increases cost of amalgam restorations
Gallium Alloys
▪Mercury free metallic restorative materials
proposed as substitute for mercury containing
amalgam are gallium containing material and
pure silver and/or silver based alloys.
▪Puttkammer (1928), suggested use of gallium in
dental restoration.
▪Attempts to develop satisfactory gallium
restorative materials were unsuccessful until
Smith et al in 1956, showed that improved Pd-Ga
and Ag-Ga materials has physical and mechanical
properties that were similar to or even better
than those of silver amalgam
Advantages of gallium based alloys -

▪Rapid solidification
▪Good Marginal seal by expanding on solidification
▪Heat resistant.
▪The compressive and tensile strength increases with
time, comparable eith silver amalgam
▪Creep value are as low as 0.09%
▪They expands after setting therefore provides better
marginal seal
Biologic Considerations of gallium based alloys -

▪Surface roughness, marginal discolouration and

fracture were reported.
With improvement in composition, these defects
were reduced but not eliminated.
▪Could not be used in larger restorations as the
considerable setting amount of expansion leads to
fracture of cusps and post operative sensitivity.
▪Cleaning of instruments tips is also difficult.
▪Less popular because it is costlier than amalgam.
Thankyou...