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Dental Materials 25/4/2012

Lec. By Dr. Mohammad Rababaa
Amalgam

Before we start with amalgam lets have a small revision about
Composites:
1) Its a direct restorative material.
2) Dentists start using composites in the late 50s; they were first produced
in 1955 when by mixing silicate with acrylic.
* Materials used in dentistry are categorized as:
- Metal alloys.
- Ceramics.
- Polymers.
3) Generally Composites are a mixture of polymers and resins, but to be
more specific they are composed of:
A) Fillers (ceramic quarts and glass).
B) Matrix (mainly Bis-GMA).

* Amalgam, what is it:
- Dental amalgam is an alloy of mercury (Hg), silver (Ag), copper
(Cu), Tin (Sn). It may also contain Palladium, zinc and other
Elements.
- King of restorative materials, its usage begun 150 years before composites
- A cheap material
- Easy to use
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- Not affected by erosion or abrasion (like enamel).
But why they stopped using it?
1) Aesthetic: due to its color, in best conditions shinny silver but after
applying it and with time it will be black which give an unpleasant view.
2) Contains toxic materials such as mercury which affect the nervous
system.
3) Biomemic approach: it doesnt make any bonding with the tooth
structure so we need to do a micromechanical detach.
* More details about this subject will be discussed next year.
*Note:
Amalgam vs. composites to restore a tooth
In amalgam restoration we make a cavity in the tooth structure
But in composites we just open the tooth pores then we fill it .

* Amalgam in dental practices:
1) In restoration of posterior teeth.
2) Foundation restoration.
3) Cores for crown.

* Amalgam comes in a precapsulated form:
The amalgam capsule contain to compartments ( amalgam alloy , mercury )
between them a membrane , when we want to make amalgam we press on
the capsule so the two compartments will come out , then we transfer
them to a device called Amalgamator or Triturator in order to mix them
well. After that we place it in a already prepared cavity where condensation
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takes place, remove the excess and complete the rest steps to get it similar
to the tooth structure.
* Remember that in any restoration procedure we have 3 times :
Mixing time , working time , setting time .

* Amalgam Advantages:
1) As we said before its easy to use .
2) Condensable , compared to composites which is not .
this advantage makes its contact with posterior teeth a tight contact ,this
contact cant be accomplished when we use composites .
3) Durable , has a long service life ( > 8 years ) thats why its a good
restoration material.

* Amalgam Disadvantages :
1) Not like tooth structure ( shinny silver turn to black ) .
2) Marginal break down
3) toxic .
* More disadvantages found in the Drs slides

* Main components of Amalgam:
1) Zinc (Zn) : found in the amalgam alloy component of the capsule .
Function: an deoxidizer , facilitate the production of the alloy by
reducing oxygen production during the condensing reaction between
silver(Ag) and mercury (Hg) which is difficult to happen without it .
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Abnormal delay expansion is caused by Zn :
Expansion of the amalgam within the tooth cavity that cause pain , crack or
fracture of the tooth , this expansion is due to the reaction of Zn with saliva
and moisture found in the oral cavity . So the manufacturer should put a
warning on the amalgam that contain zinc from this abnormal delay
expansion .
2) Mercury ( Hg) : the second component of the capsule.
3) Copper (Cu) : amalgam is divided into 2 types according to its copper
content to low copper alloy and high copper alloy .
The presence of it in amalgam produce the (gamma) phases which are
,1,2

* The basic reactions ( phases) to produce amalgam :
Amalgam alloy + mercury (Hg) > amalgam
This happens on 3 phases :
1) phase : Ag + Sn
- represent the reaction between silver and tin .
- First one to occur ( before the mixing of Hg with amalgam alloy)
- The main and strongest phase of all .
2) 1 phase: Ag + Hg
3) 2 phase : Hg + Sn
- The weakest phase .
* 1 , 2 phases they are the mixing reactions , for the production of a
conventional amalgam .
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* In the production of alloys :
The metals in the alloy mix together but they dont undergo a real reaction
( its phases rather than reactions ) .
In the production of amalgam other phases may occur :
Phases in amalgam alloy and set
dental amalgam
Formula
(gamma) Ag3Sn
1 Ag2Hg3
2 Sn7-8Hg
| Ag4Sn (silver- rich)
c Cu3Sn
q Cu6Sn5
Silver-copper eutectic Ag-Cu
* this table is similar to a table in the Drs slides so please check it .
- | phase similar to phase
-c phase takes place in high copper alloys
-q phase is a weak phase
- the synthesis of low copper alloy is easer than the synthesis of high
copper which has better properties .

* Amalgam alloy types based on production techniques: ( powder
amalgam)
1) Lathe cut :
- as the Dr said ) (
-The cuts has no regular shape
- In order to determine thethe size of the cuts we do something called grain
defining
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Size range 60-120 m and 10-20m in length
- how these cuts are produced:
1) the amalgam elements is heated to a high temperature ( 300-400 c )
2) then the phases mentioned previously occur .
3) transfer it to the lathe cut machine which is called Homogenizing anneal.
- lathe cut is not homogenous
- the aim of the condensation reaction is to make the amalgam reach the
edges of the cavity , when using lathe cuts we need to make a high
condensation force to accomplish that.
2) Spherical alloys:
Amalgam is melted but instead of cutting it mechanically as in lathe cut ,
they cut it by using a inert gas with a high pressure to get spherical droplets
of amalgam .
3) Admix:
- between lathe cut and spherical but better than both .
- high mercury content .
* About Mercury :
- Between amalgam sphericals we have mercury this mercury will react
with the present alloys but at the end we dont want excess mercury ,
because less mercury means better phase ( which is the main phase)
- liquid form in the amalgam capsule
- can enter between spheres better than lathe cut due to small surface area
per volume for spheres.
-less mercury means better properties for amalgam .
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* Amalgamation Process (Trituration Process) :
- In low copper alloys : 1,2 phases are more seen but we still have phase
because its the main phase.
- In high copper alloys: Very low amount of 2 phase which is good because
its the most corrosive, creep and prone phase.
* Considering the mechanical properties , high copper alloys has better
properties than low copper alloys .
* Note:
A number of reactions found in the Drs slide , he said that we must
memorize them because are important for now and later on. Dont forget
to check them

* Low copper alloy mixing :
- The main phase is phase although its found in low amount in it but its
not completely absent because as we said before its the strongest phase of
all phases.
* phase represent the unreacted amalgam ( remember its the phase before mixing alloy with
mercury )
- after putting the unreacted amalgam the condensing reaction occur (
1,2 occur on order to condense amalgam) , 1and 2 phases fill in the
spaces between the phase this will produce a high bonding .

*High copper alloy mixing :
- The purpose of synthesizing these alloys is to get red from 1,2 phases ,
the weakest . so they are found in low amounts .
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- In the mixing a competition will occur between copper (Cu) and tin (Sn) on
mercury resulting in q phase .
- The more the condensation reaction was good the less the mercury
content , the best properties we can get.

* Diagram phase: ( found in the slides)
On the diagram we can see 3 phases: solid phase, compound phase and
eutectic mixture
- About eutectic mixture, has a melting point this melting point is less than
the melting point range for the elements participating in the mixture.
For example: silver copper eutectic alloys : ( has a specific concentrations)
71.9 wt % Ag and 28.1 wt % Cu
If these concentrations change the melting point will change ( instead of
melting point we will have a melting range ) .

* Properties of amalgam : ( according to the American dental association ADA)
1) Dimensional changes:
- it should not contract nor expand beyond 20 m/cm within 5min 24
hours . thats why we shouldnt do major preparations before the pass of
24 hours .
* This property makes composites better than amalgam because as we
know composites can be cured by light in a short time leaving it prepared
for any major preparation, unlike amalgam it need 24 hours.
* Degree of conversion for composites is 70 80 %
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- Any material specially metals have Soliveration shrinkage and contraction
like the delayed expansion caused by Zn .
- Because of this expansion a gap between amalgam and the tooth
structure will be formed , saliva and other fluids inter this gap and reach the
dentinal tubules which cause many problems .
To avoid this gap :
1) Cover the cavity by varnish to close the dentinal tubules .
2) Use bonding agents.
3) Advise the patient to take care when eating or drinking for a period of
time .
* but in most people this gap dont occur.

* Amalgam with time :
Forces are exerted on amalgam this will lead to propagation on the walls, a
high percentage of marginal break down is formed this will increase with
time.
Why does it happen?
This occur due to 2 phase .
High copper alloys have a high compositional strength but 2 phase in
those alloys found in small amount , so marginal break down is less in high
copper alloys.
- More initial phase( phase) means waiting less time in order to work with
amalgam ( like 8 min) we can benefit from that by reducing :
1) clinical steps.
2) Waist o clinical materials.
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3) restoration time.
High copper alloys have this properties but low copper alloys dont , when
using them we need to wait 24 hours.

2) Manipulation:
- One of the most things that decrease the strength of any material is
pores, we need to reduce these pores on amalgam as much as possible in
order to increase its strength .
- Creep : break down between amalgam and the tooth structure cavity due
to occlusal forces.
- the least manipulation found in high copper alloys as admix , because it
contain little mercury so its strong.
- in the tirturation or amalgamation process:
Over tirturation will make amalgam very hard and difficult to manipulate.
Under tirturation will make amalgam in the fluid form.
Both conditions alter the mechanical properties and not good, we need an
adequate tirturation to get the amalgam with the best properties.

3) Viscoelastic material:
- when its under an applied load, then we remove this load the material will
recover slowly or there will be a degree of permanent deformation in it.

4) Condensation:
- Done by a condenser ( flat end instrument)
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- In order to do it you need to move the patient head.
- The condenser works by tightening , it is tightened well by applying a force
equal to the force you use to press on your finger nail and turn its color into
white.

5) Finishing of amalgam:
- its done after 24 hours.
- But dentists dont like to do finishing because a shinny tooth is the last
patient want ! ( finishing will make it shinny thus its not like tooth color) .
*Note:
The setting time depend on the manufacturer , according to that we have 3
types of setting time :
1) Fast set amalgam takes 1.5 min to dry
2) Normal set amalgam takes 2- 3 min to dry
3) Delay set amalgam just used in special cases.

* About Amalgam toxicity :
- The Dr recommended an article in the journal of American dental
association to read .
- Amalgam can cause multiple sclerosis, renal dysfunction and other
diseases.
- Nowadays many countries prevent using amalgam like Sweden but its still
being used in USA.
* Mercury forms:
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1) Methyl and ethyl mercury.( the most toxic form)
2) Vapor
3) Inorganic compound .
- Amalgam gets its toxicity from its mercury content that is not bound with
the amalgam alloy.
- Amalgam can be poisoning and cause pollution if it was disposed in an
inappropriate way :
Most dentists dispose amalgam in the sewerage which is totally wrong !
The appropriate way to dispose excess or old fillings amalgam is to put
them in a container and then send them to be recycled.
Recycling is done by using a special type of bacteria that extract mercury
from amalgam.

* Amalgam Hygiene Protocols:
- Mercury found in other medical applications beside dental amalgam.
1)All individuals that deal with amalgam must take the cautious and
prudent, like dentists and there workers.
For dentists , during amalgam setting they must wear a lab coat to prevent
mercury to come out their clinic.
2) The usage of an amalgam separator , which is used to collect amalgam
for recycling .
3) The dental office must be well-ventilated.
* NO carpets are allowed !
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Because in case of a mercury spill on the carpet it will absorb it , by time
this mercury will evaporate eventually any one in the place will be
poisoned.

* What we do if we have a mercury spill ?!
We never use any house hold cleaning materials , ammonia or any
substance with a gas content instead we carefully put it in a container .


You may think its a too long sheet , but in that day the dr gave us 2 lectures about
amalgam ! So good luck in studying it

The End

The greatest barrier to success is the fear of failure .
Done By : Duaa Momani





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