Amalgam or composite fillings — which material lasts longer?

Abstract

There is low-quality evidence to suggest that resin composites lead to higher failure rates and risk of secondary caries than amalgam restorations.

Amalgam and resin composite longevity of posterior restorations: A systematic review and meta-analysis

“…29 In contrast, factors such as adhesive technique, adhesive system, polymerization shrinkage, type of dental substrate (enamel / dentin) and the quality of the hybrid layer can act critically towards adhesive failure in the composites, thus increasing the risk of recurrent caries. With regard to fractures, there was no statistically significant difference between the two materials (P = 0.46), which was also observed in another study, 26 indicating a lower sensitivity of the posterior restorations to fracture when compared to recurrent caries. M a n u s c r i p t 9 In summary, the meta-analysis based on the results of the eight studies included showed a higher longevity of the amalgam restorations compared to composite resin restorations.…”

The use and repair of dental amalgam restorations as practised in South Africa

“…If dental amalgam were no longer available as a restorative material, populations with high caries rates could therefore be disadvantaged. 16 The most recent data records dental amalgam being used by 85.8% of dentists in South Africa. 19 In these situations, extending the longevity of defective dental amalgam restorations with a repair or refurbishment may be an excellent alternative for increasing the longevity of the restoration and ultimately, the tooth.…”

“…However, a Cochrane Review published in 2014 concluded that the failure rate for composite restorations was twice that of amalgam restorations. 16 Despite this, increasing concern over aesthetics, the recent Minamata Convention on Mercury 17 and advances in adhesive dentistry have globally decreased the acceptance of dental amalgam among dentists and patients alike. 18 saDJ september 2017, Vol 72 no 8 p366 -p371 rZ adam 1…”

Comparative Study Between the Effect of Class Ii Amalgam and Composite Restorations in Posterior Teeth on Periodontal Tissues Health

“…Currently, direct composite restorations are only indicated when patients have excellent oral hygiene, due to the greater adherence of plaque that occurs on this type of materials [29] . The higher probability of having more plaque adhesion on resin-based materials than in amalgam, calls for even more detailed instructions that have to be given to the patient, regarding oral hygiene, when these materials are selected [30] .Thus, a flawless restoration placement and, simultaneously, appropriate oral hygiene, have a positive effect increasing the longevity of restorations and decreasing their need of replacement [31,32] .…”