From Volume 40, Issue 4, May 2013 | Pages 260-274
Dental amalgam has helped maintain dental public health in the developed world for over a century. However, its days appear to be numbered. Notwithstanding the environmental consideration, there is an ever increasing demand from dental patients for non-metallic and tooth-coloured restorations in their posterior teeth. This paper gives a brief history of dental amalgam and critically appraises the alternative materials, the principal of these being resin-based composite.
The first issue of Dental Update contained a paper on pinned retention for amalgam and, while the current status of pins is also discussed in this issue, this paper aims to examine the current status of dental amalgam and alternatives for directly placed Class I and II restorations.
The history of amalgam is uncertain: however, there is a report of the use of a silver paste being used as early as 659AD in China,1 with its first use as a dental material being reported in France in 1826.2 The years passed, with many other metals being combined with mercury, until GV Black produced a formula, in 1895, for a dental amalgam which provided reasonable clinical performance. This remained unchanged for circa 70 years3 until Eames4 recognized the benefit of a 1 to 1 ratio of mercury to alloy, thus allowing a substantial reduction from the levels previously recommended (as high as 8 to 5). High copper content alloys followed, with these creating a copper-tin phase which was less susceptible to corrosion than the tin-mercury gamma 2 phase present in low copper content alloys.3
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