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Historically, dental amalgam is the world's most commonly used restorative material. Its use is declining due to patient and professional demand for tooth-coloured restorations that are adhesive and promote minimally invasive tooth preparation techniques. Significant reduction has also resulted from environmental concerns relating to dental amalgam's ~50% mercury content. This paper provides a comprehensive review of the status of dental amalgam including its advantages and disadvantages, amalgam safety, regulations and legislation and a comparison with alternative restorative materials. As the undergraduate teaching of amalgam procedures has progressively declined, this paper also provides an illustrated step-by-step revision guide to the materials, equipment and clinical techniques that will optimize the restoration of challenging, complex cavities, where amalgam is still considered by many to be the material of choice.
CPD/Clinical Relevance: Amalgam remains an excellent restorative material for long-lasting restorations in large/complex cavities and where moisture control presents challenges.
Article
Dental amalgam has been used for innumerable restorations over more than 150 years. It has been the subject of an unparalleled level of clinical and laboratory research, and its advantages and disadvantages are widely documented along with the evidence base for its successful use.1,2,3
Although amalgam is a safe, durable and cost-effective restorative material with excellent mechanical properties, its use is declining for a range of reasons (Table 1).1,2,3,4,5,6,7,8
As dental amalgam contains approximately 50% mercury it has always been the subject of controversy. If presented as a new material today, it would not be licensed for patient use.3
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