AMALGAM Indications Class I occlusal, lingual, buccal pits Class II- MO, DO Class III- D surface, Li access Class

ss Class V- posterior teeth (palatal, lingual aspect) Class VI For core build up To seal apex after apicoectomy (removal of entire apical area)

o o o o o

Need small amount of Hg Resist tarnish and corrosion Stronger set Smooth surface finish Produce more compact filling with less voids in between particles

ALLOY vs. AMALGAM Alloy is a mixture of 2 or more metals Alloy= M1 + M2 + Mn! Amalgam is a mixture of Hg with one or more metals Amalgam= Hg + M1 + M2 Amalgamation- reaction where a silver based alloy is mixed with mercury, a liquid metal Why Amalgam? -inexpensive -ease of use -proven track record -familiarity -life expectancy (15yrs) -resin free (less allergies than composite) Composition of Dental Amalgam Basic Alloy o Silver o Tin o Copper o Zinc Mercury Other Metals o Palladium o Indium Procedure of Amalgamation Process 1) Selection/ Proportioning of Alloy & Hg 2) Trituration Process 3) Kneading and Mulling 4) Removal of Excess Mercury 5) Condensation 6) Burnishing 7) Carving 8) Polishing 1) Selection and Proportioning Alloys Type I/ A: powder form -class I lathe cut -class II spherical -class III dispersed Type II/B: pellet or tablet form -class I lathe cut -class II spherical -class III dispersed Dispersed Alloy -contain lathe cut particles of classical composition and spherical particles of silver (72%) and copper (28%) -advantages:

Silver (Ag) o 65-75% of amalgam alloy o properties: RSES C -increases reactivity to Hg -increases strength -increases expansion -increases ST -decreases corrosion Tin (Sn) o 25-27% of amalgam alloy o properties: SF ES -increases ST -provide flow and shrinkage -decrease expansion -decrease strength Copper (Cu) o 6% o Properties: SM TCC -increases strength and manipulability -decrease tarnish and corrosion -reduces creep (reduces marginal deterioration) Zinc (Zn) o 1-2% o Properties: SRC S -act as deoxidizer/scavenger (decreases oxidation of other elements) -causes delayed or secondary expansion (if contaminated with moisture during condensation) (causes lateral pressure or extrusion of Amalgam) (cause postoperative pain) -increase surface roughness and corrosion of Am -decreases strength of amalgam Other Metals Indium (In) S STCMB -decreases surface tension (reduces amt of Hg necessary) (reduces emitted Hg vapor) -reduces creep and marginal breakdown -increases strength -must be used in admixed alloys -example (indisperse distributing company 5% indium) Palladium (Pd) -greater luster -reduced corrosion -example (valiant PhD) (0.5% Pd) Mercury (Hg) -only pure metal which is liquid in room temp. -mirror like appearance -purity is certified USP -toxic in pure state -when mixed with alloy, toxicity is neutralized -when amalgam restoration is subjected to 80C free form of Hg will rise to the surface thus releasing toxic effect -activates amalgamation reaction Alloy: Hg ratio o Lathe cut 5:8 o Spherical 5:6 o Dispersed 1:1 Trituration Process

-mixing of alloy and Hg to produce a plastic mass Purpose -to remove surface coating of alloy -to reduce size of the alloy -to provide proper union of alloy and Hg Techniques Manual -use of mortar and pestle -press amalgam pellet against wall of the mortar -45-60 sec mixing time mechanical -use of amalgamator -has a piston inside to serve as pestle -7-8 sec mixing time Good Amalgam Mix -must look smooth, a little shiny and not grainy -should easily curl down at the sides of the mortar (clings when there is too much mercury) (overtrituration makes the mixture cling to the sides of mortar -should register fingerprints -should form a hemisphere when dropped Kneading and Mulling -purpose: to make the amalgam mass more homogenous -steps: o Place the mix on a rubberdam sheet o Knead the mix then roll into rope like mass -incorrect mix o Too much Hg: mass is flat; cannot be rolled o Too much Alloy: dry, easily breaks Removal of excess mercury o Transfer the contents into a squeeze cloth o Use cotton pliers to hold the cloth then twist the cloth to remove excess mercury Condensation -packing the amalgam into the walls of the cavity purpose: -to force amalgam restoration against each other and onto the wall of the prepared cavity -to remove excess Hg -to produce an Amalgam mass capable of being carved Instruments used -amalgam carrier -amalgam condenser Techniques o increasing dryness technique -squeeze cloth is twisted after an increment is placed -drier increments blots out the excess Hg fr. Previous increment o Minimal mercury technique -at the start of the MIV, only minimal content of Hg is used Burnishing Purpose: -to allow amalgam to flush against the walls of the cavity preparation -to prevent marginal leakage Instruments used: -amalgam burnisher Carving Purpose: -to restore the normal anatomy and contact areas of the tooth Instruments used -cleoid/discoid carver -hollenback carver -anatomical carver -carve as soon as the restoration offers resistance to the carver -if done too soon (Amalgam ditching (presence of v-shaped cuts on the surface)) (marginal leakage) (secondary expansion) Polishing Purpose: -to produce a smooth and lustrous surface to reduce plaque adherence and tarnish and corrosion -done after 24 hrs Instruments: -handpiece with water as a coolant -series of abrasive burs -after 1 hr, CS of Am is only 11,600 psi -after 6 hrs, only 70% of total CS is achieved Dimensional changes related to amalgam Contraction Cause -too much alloy -overtrituration -overcondensation effect -marginal leakage -secondary caries expansion causes -too much Hg -under trituration -undercondesation -presence of moisture -presence of zinc -premature contact with saliva -use of wet instruments effects -lateral pressure on tooth -premature contact on opposing tooth (lead to pain) AMALGAM Advantages -less technique sensitive -more durable -less costly -excellent abrasion and wear resistance -tends to seal itself against leakage -bacteria do not adhere to it as strongly as on composites (heavy metals antimicrobial) Disadvantages -poor esthetics -no bonding to tooth surface -extensive tooth preparation -concern over mercury toxicity -galvanic effect *2 dissimilar metals contact and cause pain