Re: Other consequences of amalgam removal?

From: Dr Steve (nospam_at_home.net)
Date: 12/02/04 

Date: Thu, 02 Dec 2004 13:14:11 GMT

Amalgam restoration require lots of close attention be paid to how the
preparation is created into the tooth, but placing the material is not
tricky (not much). Composite restorations require little attention to how
the preparation is done, but needs lots of attention to how the material is
placed

Amalgam seals by forming an oxide layer. This creates an engineered amount
of expansion (about 0.01% if I remember correctly). Any exposed surfaces
are always trying to oxidize which, theoretically, would improve the seal if
anything bad happens, (not often true in real life). Composite seals by
"bonding" to the tooth walls. Depending on the brand of composite used,
there is between 1% and 10% shrinkage on hardening of the plastic. This
holds the walls of the tooth in constant tension. If parafunctional habits
exceed the bond strength of the plastic to tooth, the material will let go
of the tooth and begin leaking. There is NO mechanism (not even
theoretical) for getting that seal back. Dentists have now (assuming they
keep current) learned how to compensate for the shrinkage and get a plastic
(composite) filling to last a reasonable amount of time.

Statistically, when studied at the university level, amalgam seems to last
longer than composite on back teeth. However, studies going over 15 year
periods are not comparing the materials and techniques used now. 

-- 
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................
This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................
"Matt" <matt@themattfella.zzzz.com> wrote in message 
news:Qvurd.5829$LN.4676@news01.roc.ny...
> W_B wrote:
>> On Wed, 01 Dec 2004 23:01:38 GMT, Matt <matt@themattfella.zzzz.com>
>> wrote:
>>
>>
>>>Okay folks, I see the thread has degenerated.  I am not asking about the 
>>>effects of mercury.  I am hoping for some serious discussion of side 
>>>effects of amalgam removal.
>>
>>
>> Perhaps it is time for our buddy, Harr3y to chime in.
>> You could search for his old posts.
>>
>> He ended up with 4 - 5 RCT's
>> and 17 porcelain Inlay/Onlay restorations
>> because he thought it a good idea to remove
>> perfectly serviceable amalgam restorations.
>> He also lost a tooth because he was not keen
>> on the idea of RCT and the doc extracted his
>> tooth before he knew what happened.
>>
>> Active decay was found under all of the composite
>> restorations done by the quack he went to to have
>> his amalgam restorations removed.
>>
>> Dr SMancuso can elaborate on this case.
>>
>> This patient went through much pain and suffering
>> before his teeth were restored correctly.
>
> Thanks.  Okay, so I guess the point is that some awful things can happen 
> when composite restorations are done wrong.  Probably also that it is easy 
> to do composites wrong and easier to do amalgams right.
>
> What if the composites are done right?  Are they less likely to leak or 
> have other complications (besides mercury-related effects!) than amalgans?

Relevant Pages

  • Re: epidemiology of posterior composites
    ... composite in posterior restorations, ... amalgam is superior in its clinical ... resin composite in the posterior dentition, ... Are fillings like drugs, how do we choose? ...
    (sci.med.dentistry)
  • Re: Amalgam vs. Composite
    ... looks ugly, large filling can expand and crack tooth, can make ... With Amalgam you have minimum depth preparation ... With composite size of the decay determines how ...
    (sci.med.dentistry)
  • Re: Tooth Ache
    ... >> metal does and lead to fractures through the amalgam. ... The cement is more compressible and you will usually find these restorations ... >> CaOh has been shown to NOT effect the long term health of a tooth. ... Especially in primary teeth CaOH ...
    (sci.med.dentistry)
  • Re: Amalgam vs. Composite
    ... about composite. ... amalgam restorations under tight controls, ... the group of restorations studied was a limited number done by a few ... longevity of both materials is about the same. ...
    (sci.med.dentistry)
  • Re: Filling pain - how long to subside before doing root canal?
    ... After the gap between the amalgam and the tooth ... Composite actually bonds to tooth structure. ... removal, uncontaminated tooth surfaces, and quality materials used ...
    (sci.med.dentistry)