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    Minimal Invasive Dentistry: Marinescu Andrada Gr. 3 Anul V MD Eng

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    Anamaria Polgar
    The document discusses minimal invasive dentistry and compares dental amalgam and composite materials for restorations. It notes that amalgam has been used for over a century but has toxicity concerns from mercury. Composite materials provide aesthetic and biocompatible alternatives that bond to tooth structure, allowing for more conservative preparations. The document analyzes the cavity preparations required for amalgam versus composite, noting amalgam requires more extensive removal of healthy tooth structure. It concludes that while amalgam is strong, composite aligns better with minimal invasive approaches through more conservative preparations and biocompatibility.

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    Minimal Invasive Dentistry: Marinescu Andrada Gr. 3 Anul V MD Eng

    Uploaded by

    Anamaria Polgar
    95 views8 pages
    The document discusses minimal invasive dentistry and compares dental amalgam and composite materials for restorations. It notes that amalgam has been used for over a century but has toxicity concerns from mercury. Composite materials provide aesthetic and biocompatible alternatives that bond to tooth structure, allowing for more conservative preparations. The document analyzes the cavity preparations required for amalgam versus composite, noting amalgam requires more extensive removal of healthy tooth structure. It concludes that while amalgam is strong, composite aligns better with minimal invasive approaches through more conservative preparations and biocompatibility.

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    Minimal-Invasive-Dentistry (1)

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    The document discusses minimal invasive dentistry and compares dental amalgam and composite materials for restorations. It notes that amalgam has been used for over a century but has toxicity concerns from mercury. Composite materials provide aesthetic and biocompatible alternatives that bond to tooth structure, allowing for more conservative preparations. The document analyzes the cavity preparations required for amalgam versus composite, noting amalgam requires more extensive removal of healthy tooth structure. It concludes that while amalgam is strong, composite aligns better with minimal invasive approaches through more conservative preparations and biocompatibility.

    Copyright:

    © All Rights Reserved
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    Download as docx, pdf, or txt
    95 views8 pages

    Minimal Invasive Dentistry: Marinescu Andrada Gr. 3 Anul V MD Eng

    Uploaded by

    Anamaria Polgar
    The document discusses minimal invasive dentistry and compares dental amalgam and composite materials for restorations. It notes that amalgam has been used for over a century but has toxicity concerns from mercury. Composite materials provide aesthetic and biocompatible alternatives that bond to tooth structure, allowing for more conservative preparations. The document analyzes the cavity preparations required for amalgam versus composite, noting amalgam requires more extensive removal of healthy tooth structure. It concludes that while amalgam is strong, composite aligns better with minimal invasive approaches through more conservative preparations and biocompatibility.

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    © All Rights Reserved
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    of 8

    Minimal Invasive Dentistry

    Marinescu Andrada

    Gr. 3 Anul V

    MD ENG
    Dental Materials: Composite
    vs. Amalgam for Minimally
    Invasive Dental Restorations

    Introduction

    In the 21st century, minimal invasive

    dentistry is a philosophy which adopts

    the goal of an intervention in which the

    conservation of a healthy tooth structure is key. This philosophy encompasses a

    rangle of clinical procedures that integrates prevention, remineralization and

    minimal intervention for the placement and replacement of restorations. This

    conservative approach minimizes the restoration/re-restoration cycle, thus

    benefiting the patient over a lifetime. The two dental materials, amalgam and

    composite resin, will be discussed and analyzed in this paper while taking into

    consideration their aesthetics, biocompatibility effects and their respective tooth

    preparations.

    Composite vs Amalgam

    The longevity of dental restorations is dependent on many factors, but one of

    the most important of them being that related to the materials used. Dental

    amalgams have been used in the dental profession for over a century because of its
    strength and durability, however, due to its inferior aesthetic appearance and

    concerns over the adverse health effects of the material, it is being replaced by

    alternative tooth coloured materials - composite being one of them. Dental

    amalgam is a combination of mercury with other metals, which is soft enough to

    adapt to the size and shape of the tooth cavity yet hardens sufficiently fast to make

    it practical. However, during the placement and removal of an amalgam filling, and

    even during the time that an amalgam filling is in place in a patient’s cavity, both

    the patient and the dentist is exposed to the mercury vapors that are being released

    through this proccess. Studies show that inhalation of mercury vapors may produce

    health effects such as bronchitis, pneumonia, brain and kidney damage, however,

    there needs to be a high concentration absorbed into the lungs for this to occur. The

    main adverse effect of amalgam fillings is the local effects caused in the mouth,

    such as allergic reactions of the gums and oral mucosa. Additionally, pregnant

    women must also try to avoid this type of restorative materials due to its effects. In

    conclusion, amalgam may constitute potential toxic hazards to patients through

    mercury release and absorption, surface corrosion, and the reaction of released

    mercury with residual alloy particles from an amalgam restoration into the enamel,

    dentin, pulp tissues, and adjacent gingival tissues where it accumulates. Among the

    disadvantages of amalgam as a restorative material, some are: its unaesthetic

    appearance, tarnish and corrosion, it lacks chemical or mechanical adhesion to


    tooth structure therefore requiring a meticulous cavity preparation and healthy

    tooth removal to provide mechanical retention, it is a brittle material with low edge

    strength which requires bulk for strength, it has a high thermal conductivity, it

    promotes plaque adhesion and finally, requires special waste handling.

    Composite, on the other hand is a tooth-colored plastic and glass mixture

    that provides good durability and resistance to pressures of constant stress and

    chewing. Due to their aesthetic features, it can be used in both frontal and posterior

    teeth, offering a more natural result. As opposed to amalgam materials, composites

    offer excellent resistance to corrosion, chemical attack and outdoor weathering. In

    addition, composite materials are insulative materials, they are repairable, they can

    be polished during the same appointment as the tooth filling, and most importantly,

    they bond to the tooth structure which means that less healthy tissue is removed

    through preparation, which is an important component of the minimal invasive

    philosophy.

    Minimal Tooth Preparations

    Conventional preparations are based on the theory of “extension for

    prevention” and the needs of the restorative material rather than the health of the

    tooth. Minimally invasive dentistry offers a more conservative preparation as seen

    in composite restorations as opposed to large amalgam preparations which require


    more healthy tooth structure to be removed. An amalgam restoration has the

    following cavity preparations:

    - 90 degree cavosurface angle

    - the walls must be parallel or perpendicular to occlusal loads

    - a definite gingival seat of 1.5-2mm. in depth for compound cavities

    - rounded internal line angles

    - sufficient bulk at the isthmus area

    - each portion must have its own independent retention and resistance

    A composite restoration has the following cavity preparation:

    - minimal extention

    - pulpal and axial walls of varying depth

    - enamel bevel

    - butt joint on root surface


    - tooth preparation walls must be rough

    As a cavity outline form, amalgam prepartions must include all pits and fissures

    and adjacent suspicious areas; for class ll tooth preparations, proximal contact has

    to be broken. For composite restorations, they must include faults but they need

    not be extended to adjacent pits and fissures; for class ll preparations, proximal

    contact need not be broken. The pulpal depth of an amalgam restoration must be

    uniform, with a minimum depth of 1.5 mm, while for a composite restoration, the

    pulpal depth does not need to be uniform, and a depth of 1.2mm is usually

    sufficient. The axial depth for an amalgam preparation should be uniform, with a

    depth of 0.2 - 0.5 mm inside the DEJ, while for a composite restoration the axial

    depth does not neccessarily need to be uniform, while the depth is made to extent

    of the defect. For secondary retention, amalgam preparations have grooves, slots,

    pins and locks while for composite preparations these secondary retentions are

    indicated only for extensive preparations, not all. In conclusion, tooth preparations

    that are to receive an amalgam restoration are much more extensive and must be of

    a certain depth to achieve proper retention, as compared to a composite preparation

    which is limited to the cavity, shallow or deep, small or big. This is why, in my

    opinion, composite restorative materials are much more minimally invasive.

    Conclusion
    In conclusion, although amalgam is a durable and strong material, especially

    for posterior restorations, it is still considered to contain a toxic material which can

    pose a threat to the health of patients. Additionally, it does not comply with the

    importance and the philosophy of minimal invasive dentistry used in today’s

    society, as it requires a more extensive removal of healthy tooth structure in order

    to offer resistance to the filling. Composite material is not only much more esthetic

    and can be used in both anterior and posterior teeth, but it is also much more

    biocompatible. It is up to the patient and doctor to discuss the options available

    and come to a final decision as to which material would best fit the needs of the

    patient, while also respecting biocompatibility considerations of each material.


    References
    Pleva J. Mercury poisoning from dental amalgam. J Orthomolecular
    Psychiatr. 1983;12(3):184–193.

    http://www.jresdent.org/article.asp?issn=2321-
    4619;year=2016;volume=4;issue=2;spage=25;epage=30;aulast=Pereira

    http://www.kumardds.com/restorative

    https://jada.ada.org/article/S0002-8177(14)65274-0/fulltext

    https://ec.europa.eu/health/scientific_committees/opinions_layman/en/dental
    -amalgam/index.htm

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