Dental Amalgam: the Materials

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Abstract
The goal of this presentation is to describe the material as it is used clinically, explain why small quantities of Hg can be released, and suggest ideas for amalgams that do not release mercury. A set amalgam is a dynamic material that undergoes many microstructural changes during clinical use, related to both the elevated temperature and corrosion-prone environment in the mouth and mechanical forces applied to the restoration. Amalgams can be divided roughly into two groups by their copper content: low Cu (traditional) and high Cu. High-Cu amalgams generally perform better clinically, but all amalgams corrode to some extent in the mouth. Some corrosion is deemed to be a positive factor, because corrosion product deposition reduces leakage at the margins of restorations; that is, the restorations are partly self-sealing. One of the reasons cited for the improved clinical performance of high-Cu amalgams over low-Cu amalgams is that the corrosion-prone phase, γ 2, is nearly eliminated in high-Cu amalgams. Future research should involve improvements in the clinical performance of dental amalgams, studies of the mercury release from various types of amalgams and the toxic potential of this exposure, and the development of new amalgam systems that reduce the mercury exposure. Although the longevity of modern amalgams is impressive, it is important for their stability to be increased both clinically and microstructurally. An amalgam should be developed with a stable microstructure that, once set, would not change during clinical use. Microstructural changes lead to clinical deterioration. A stable system would not corrode, and the matrix transformation γ 1 to β1 would be prohibited. The latter effect could be achieved by stabilization of the γ1 phase or development of a system that would form the stable β1 phase during amalgamation. Such a system would simultaneously improve clinical performance and reduce the potential for biological side-effects from its deterioration. Studies of the potential for Hg release should be conducted with proper consideration of the microstructures of amalgam systems and alterations in the structures induced by clinical use. Careful studies are needed of the toxic potential from exposure to these materials as they are used clinically.