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Article: Volume 48 Number 8 Page 607 - September 2021

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  Dent Update 2021; 48: 607-618

Restorative dentistry:  Dental Amalgam: A Practical Guide

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Abstract: 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.

Clinical relevance: Amalgam remains an excellent restorative material for long-lasting restorations in large/complex cavities and where moisture control presents challenges.

Author notes: Louis Mackenzie, BDS, FDS RCPS(Glasg), Head Dental Officer at Denplan, GDP and Clinical Lecturer, University of Birmingham School of Dentistry. email:

Objective: The reader should gain an understanding of the value of amalgam as a restorative material despite its declining use