Implications of Amalgam and Ceramic Degradation in the Oral Environment

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Abstract
Recent breakthroughs in materials science and technology have led to improved dental restorative ceramics, metals, and resin-based composites. These breakthroughs have been most important since one of the major controversies during this period has centered on allegations of the physiological risks of mercury released from amalgam restorations. Dental amalgams have been used in the United States since 1832, yet not a single well-documented case of dental patient toxicity to mercury from amalgam restorations has been reported in the scientific literature. A particularly extreme position has been adopted by the Swedish government, which has proposed the progressive elimination of amalgam as a dental restorative material by 1997. Among the materials that have been considered as the most biocompatible alternative to amalgam are dental ceramics. New ceramic products and technologies have gained considerable acceptance in Sweden even though their safety and efficacy have not been fully established. Although dental ceramics constitute a much more costly alternative than some other materials, they offer the advantages of esthetics, inertness, durability, low thermal conductivity, and low diffusivity, as compared with amalgams. Although ceramics are generally considered to be inert in the oral cavity, there are certain phenomena associated with their use that may cause significant surface degradation of these materials and subsequent physiological side effects.