Dental Amalgam

Good morning..
1
Dental amalgam
2
Contents
Manipulation
Introduction Quality of dental amalgam
History Failure of restorations
Classification
Uses and advantages
Components and
composition Recent advances
Manufacture of alloy Gallium alloys
Mercury
Bonded amalgam restorations
Amalgamation
Properties mercury exposure
Clinical considerations Mercury hygiene
Tarnish and corrosion recommendations
Management of mercury
vapour 3
Current status of amalgam

REFERENCES
PHILLIPS Science of Dental Materials;11th ed

Kenneth J. Anusavice
CRAIGs Restorative Dental Materials;12th ed
John M. Powers, Ronald L. Sakaguchi
Materials used in dentistry 1st edition
s.mahalakshmi
Materials science for dentistry;9th ed
B.W.Darvell
Sturdevants Art & Science of Operative Dentistry; 5 th ed;
fundamentals of operative dentistry, a contemporary approach;
ed
Summitt, Robbins, Hilton, Schwartz
4
Dental amalgam: An update
J Conserv Dent.2010 Oct-Dec;13(4): 204208
The amalgam controversy-an evidence based analysis ;
JADA,Vol.132,march 2001
Effect of admixed indium on the clinical success of
amalgam restorations
. operative dentistry journal1992 Sep-Oct;17(5):196-202
American Dental Association (ADA) Council on Scientific Affairs,

Statement on dental amalgam, 2011,
Dental Materials Volume 15, Issue 6, November 1999, Pages 382-389
Biomaterials, Volume 18, Issue 13, July 1997, Pages 939-946 5
Journal of Endodontics
Volume 9, Issue 12, Pages 551-553, December 1983
Jones DW: Putting dental mercury pollution into perspective.
BDJ 2004;197:175-177.
Eichmiller FC: Research into Non-Mercury Containing Metallic

Alternatives. Op Dent 2001;6:111-118.
Ronald K Harris: Dental Amalgam: Success Or Failure?. Op

Dent 1992;17:243-252.
Dunne SM et al: Current materials and Techniques for direct

restorations in posterior teeth. IDJ 1997;47:123-136.
6
INTRODUCTION
Dental amalgam is
one of the most
versatile restorative
materials used in
dentistry.
75% of all restorative
materials used by dentists.
A dental restoration for

more than 165 years. 7
Dentalamalgam: Anupdate Conserv Dent.2010 Oct;13(4

8
Dentalamalgam: Anupdate Conserv Dent.2010 Oct;13(4

Over the last few years improvements in
composition have led to -
Reduced Early seal

marginal between the
failure due to tooth and
decreased restoration
creep and
corrosion
But development of alternatives based on ceramics

and composites , and questions on its safety have led 9
to its decline.
What is amalgam????
10
Source: Websters New World Dictionary of the American

Language, Guralnik DB, Ed., New York: World Publishing Co.,
11
Sturdevants Art & Science of Operative

HISTORY OF AMALGAM
A Chinese
medical
text(Material
medica)
mentions using
a silver
paste, a type
of amalgam, to
fill teeth in the
7th century
-by Su Kung in
659 AD
12
J Conserv Dent.2010 Oct;13(4):

8.
In Europe, Johannes Stokers,
a municipal physician in Ulm,
Germany, recommended
amalgam as a filling material
in 1528.
13
14

8.
In year 1603 tobias
dorn kreilius
Copper sulphide +
strong acids + mercury
= amalgam
D arcets mineral
cement
8 parts Bi
1 part lead
3 parts tin 15
1 part mercury
In the 18th century, John Hill, an
Englishman, described mercury as, It
penetrates the substance of all metals, and
dissolves, and makes them brittle.
In 1818, Louis Nicolas Regnart, a

Parisian physician invented amalgam
by the addition of one-tenth by weight
of mercury to another metal or metals.
Father
Dental silver amalgam was probably introduced
of
in England by Joseph Bell, amalgam
a British chemist, in
1819, and was known as Bells putty.
16

8.
Traveau described a silver
paste filing material in
1826. He produced
amalgam by mixing the
silver coins with mercury.
17
18

8.
John tomes
18 61
First research programme in amalgam
Charles tomes
18 71
Shrinkage and expansion in amalgam
19
20

8.
21

8.
Stocker 1900 s copper
amalgam
ADA specification No 1 was adapted for

amalgam in 1929.
22

8.
Gayler ML. Dental amalgams.J Inst
Metals.1937;60:40719
Greener EH. Amalgam-yesterday, today and tomorrow.Oper

Dent.1979;4:2435.
23

8.
In 1959, Dr. Wilmer Eames
recommended a 1:1 ratio
of mercury to alloy, thus
lowering the 8:5 ratio of
mercury to alloy that
others had recommended.
Eames WB. Preparation and condensation of amalgam with low
mercury alloy ratio.
J Am Dent Assoc.1959;58:7883
24

8.
25

8.
26
Amalgam wars
27
AMALGAM WARS-the
controversy
In 1841, the American Society of Dental
Surgeons declared that
the use of amalgam constitutes
malpractice
AMALGAM USE DECLINED
Dr. Christopher S. Brewster (1846) - condemned the use

of amalgam
28
The amalgam controversy-an evidence

based analysis ; JADA,Vol.132,march 2001
1842 a belief prevailed that amalgam
exerted a vitiating influence upon the fluids
of the mouth and gives rise to an unhealthy
action in the gums.
1844 - the societys members were warned

that they were to sign a pledge NEVER TO
USE amalgam or they would risk being
expelled from the membership.
29

Townsend - gave his personal
directions for preparing the amalgam,
known as Townsends Amalgam.
In 1858, Townsend reversed his stance

on amalgam and recommended
removal of teeth that could not be
saved by gold.
In 1867, the St. Louis Odontological
Society unanimously adopted a
resolution to the effect that amalgam
was injurious and detrimental to
health AMALGAM
30
Dr. J. Payne in 1874, claimed that the dental
profession was poisoning thousands of people all
over the world from corrosive sublimate generated
in the mouth from amalgam plugs in the teeth.
IN 1883, DR. ALTON H. THOMPSON COMMENTED
The presence of amalgam with us is a tremendous

fact which we must accept 31

AMALGAM WARS
the first one
In 1845, American
Society of Dental
Surgeons condemned the
use of all filling material
other than gold as toxic,
thereby igniting "first
amalgam war'. The amalgam controversy-an evidence
32

What ended the amalgam war??
33

Then came the second amalgam
war.
Controversy over amalgam use surfaced

again in 1926 and into the 1930's when a
German physician, Dr. Alfred Stock, showed
that mercury escaped from fillings in the
form of a dangerous vapor that could cause
significant medical damage.
34

During this Second Amalgam War, the
ADA vigorously defended silver
amalgam and its widespread use was
continued
35

36

1930
Charlie hospital in berlin
Committee no reason to
condemn newer silver tin
amalgams
37
Materials used in dentistry 1st edition

s.mahalakshmi
3rd amalgam war in 1980s
It was the Neurobiologist Mats Hanson,

Assosiate professor in physiology at Lund
University in Sweden, who in 1981 started
the fight against the authorities
38

39

40

but problem flared in 1990s by the
telecast of television program 60
minutes in CBC television
Dr murray from univ. of calgary
41
No clear end for 3rd
war
May 13- 1997

Safety was again
proved in media
42
Materials used in dentistry 1 edition

st
s.mahalakshmi
Current status on the
amalgam war
The amalgam war continues to

rage on today. some states
have already appointed
holistic/biological dentists to
dental boards, effectively
ending theADA monopoly on
state dental boards.
43

Current status on the
amalgam war
American Council on Health &
Science, has determined that
allegations against amalgam
constitute one of the greatest
unfounded health scares of recent
times
44

There is presently a congressional bill
in The United States House of
Representatives (H.R. 4163)
introduced by Rep. Diane Watson (D-
CA) and Rep. Dan Burton (R-IN) to ban
the continued use dental amalgam
fillings.
45

STATEMENT ON AMALGAM-
ADA
"No controlled studies have been published
demonstrating systemic adverse effects from
amalgam restorations-FDI & WHO;1997
based on available scientific

information, amalgam
continues to be a safe and
effective restorative
material.-ADA;1998
"There currently appears to be no

justification for discontinuing the use of
dental amalgam.-ADA;1998
46
American Dental Association (ADA) Council on

Scientific
Affairs, Statement on dental amalgam, 2011,
47

Scientific
there were no statistically significant
differences in adverse
neuropsychological or renal effects
observed over the 5-year period in
children whose caries are restored
using dental amalgam or composite
materials- Journal of the American
Medical Association(JAMA)
andEnvironmental Health
Perspectives;2006
48

Scientific
49

Scientific
Classification of Amalgam
A) According to Alloyed
Metals
Binary alloy
(Ag-Sn)
Number
of
alloyed
metal
Quarternary
Tertiary
alloy
alloy
(Ag-Sn-Cu-
(Ag-Sn-Cu)
Zn) 50

Dentistry; 5th ed
B) According to shape of powdered
particle
Lathecu spheric
t al
Admixe
d
51

Dentistry; 5th ed
Particle Shape
Lathe cut Spherical

low Cu low Cu
New True Cavex SF
Dentalloy high Cu
high Cu Tytin, Valiant
ANA 2000
Admixture
high Cu
Dispersalloy, Valiant
PhD
52
C) According to copper
content
Low copper High copper

amalgam(<0- amalgam(>6-
6%) 13%)
53

Dentistry; 5th ed
D)According to zinc content
Zinc Non zinc
containing containing
alloy alloy
(>0.01-2%) (<0-0.01%)
54

Dentistry; 5th ed
E)Generations based on the
improvement in composition
1st 3Ag +
generation Sn
2nd 3Ag + Cu Zn
generation Sn Ag3C
3rd 3Ag +
uCu
generation
4th Sn
A Ternary
Sn upto
generation g alloy
29%
A C
5th Sn
Quaternary alloy In
g u
generation
A Eutectic
C 1st, 2nd, 3rd
6th Pd+ generation
g alloyu
55
generation
Components of dental
amalgam
Other
Zinc
Indium 56
Palladium Phillips Science of Dental Materials;11th

Silver(Ag)
57
Phillips Science of Dental Materials;11th

Tin(Sn)
58

Copper(Cu)
59

Zinc(Zn)
60

Indium(In)
61
operative dentistry journal1992 Sep-

Palladium (Pd)
reduced corrosion `
greater luster
example
Valiant PhD (Ivoclar Vivadent)
0.5% palladium
62
Mahler J Dent Res 1990

Dental Materials Volume 15, Issue 6, November 1999,
Pages 382-389
Biomaterials, Volume 18, Issue 13, July 1997,

Pages 939-946
63
Mercury (Hg) - only
pure metal that is liquid
at room temperature
64

Alloy Powder Composition
Type Ag Sn Cu Zn Other
Low copper 63-72 26-28 2-7 0-2
High-Cu admixed lathe-

cut 40-70 26-30 12-30 0-2
High-Cu admixed
spherical 40-65 0-30 20-40 0 0-1 Pd
High-Cu single spherical

0-5 In,
40-60 22-30 13-30 0
0-1 Pd
compositions in weight percent
65

Alloy Powder: Dispersalloy
Silver
69%
Zinc
1% Copper Tin
12% 18%
Mixing proportions: 50% alloy, 50% mercury

66

Alloy Powder: Tytin
Silver
59%
Tin
Zinc 13%
0%
Copper
28%
Mixing proportions: 57.5% alloy, 42.5% mercury

67

Phases in Amalgam Formula
Alloys and Set Dental
Amalgams
Ag3Sn
Ag2Hg3
Sn7-8Hg
Ag4Sn (silver-rich)
Cu3Sn
Cu6Sn5
Silver-copper Ag-Cu
eutectic
68

BASIC COMPOSITION
A silver-mercury matrix containing filler particles
of silver-tin.
Filler (bricks)
Ag3Sn called gamma can be in various
shapes irregular (lathe-cut), spherical or a
combination of both.
Matrix
Ag2Hg3 called gamma 1 - cement
Sn7Hg called gamma 2 - voids
Ag3Sn
Ag2Hg3
69
Sn7Hg8
70
In low copper conventional amalgam alloy.
Ag3Sn + Hg Ag2Hg3 + Sn7-8Hg + Ag3Sn

( ) ( l) ( 2) ( ) (unreacted)
71
ADMIXED ALLOYES AND UNICOMPOSITIONAL ALLOYS
Ag3Sn + Hg Ag2Hg3 + Sn7-8Hg + Ag3Sn

() (l) (2) () (unreacted)
Ag3Sn + Ag-Cu + Hg Ag2Hg3 + Sn7-8Hg + Ag3Sn +Cu3Sn + Cu6Sn5 + Ag-Cu

1 + 2 1 2
1 + 2
After
Ag3Sn + Ag-Cu + Hg Ag2Hg3 + Ag-Cu +Cu3Sn + Cu6Sn5 + Ag3Sn.
One week
1 + 2 1 1 + 2

After
Ag3Sn + Ag-Cu + Hg Ag3Sn + Ag-Cu + Ag2Hg3 + Cu6Sn5
One year
1 + 2 1 + 2 1
72
Unicompositional
Ag3Sn + Cu3Sn + Hg Ag2Hg3 + Cu6Sn5 + unreacted alloy particles

1
73
Silver-Tin (Ag - Sn) System
Most commercial alloys fall within the limited composition

range of B to C i.e ( + ) and
If Sn > 26.8 wt% + Sn-rich phase is formed. 74
Conventional Low-Copper
Alloys
Dissolution and precipitation

Hg dissolves Ag and Sn
from alloy
Intermetallic compounds
formed
Ag3Sn + Hg Ag3Sn + Ag2Hg3 + Sn8Hg

1 2 75
CRAIGs Restorative Dental

Gamma ( ) = Ag3Sn
unreacted alloy
strongest phase and
corrodes the least
forms 30% of volume
of set amalgam
Gamma 1 ( 1) = Ag2Hg3
matrix for unreacted alloy
and 2nd strongest phase
60% of volume
76

IMPORTANCE OF 2 PHASE:-
Sn Hg in a set amalgam may be reduced in

8
quantity or even eliminated by the
presence of phase (Cu3Sn)
Potentially valuable reaction for several

reasons:-
tin act as a most electropositive

element present in absence of Zn, so
with high activity in the 2 phase, it
makes the most electropositive phase,
hence the most easily corroded 77
Materials science for

dentistry;9th ed B.W.Darvell
2 phase is extremely
weak & soft, deforming
readily & the strength of
amalgam is limited by its
presence
Contributes to static creep

of amalgam 78
Materials science for dentistry;

B.W.Darvell
Scanning electron microscopic view of SnHg (2) crystals, that occurs
in the matrix of set low copper amalgam
79

COPPER
Improves strength of the resulting amalgam

But if in excess, leads to expansion on setting
80

B.W.Darvell
Depending on its quantity & amt of Sn in the alloy, it
may present as:-
1.Cu3Sn (-phase)
2.Cu6Sn (-phase)
As solubility of Cu in and 1 phase is low, thus

Cu-Sn
phase formed during setting process will probably be
phase
81

B.W.Darvell
SLOW
REACTIONS
The reaction rate of or phase Ag-Sn with Hg is
sufficiently fast that the 2 phase is always formed
initially, but Cu3Sn ( phase) & 2 phase cannot exist
together for long & relatively slow reaction must occur.
+ 2 +
(Hg)
82

B.W.Darvell
This is at relatively low rate because
it is a solid state reaction
Also the 2 phases will be distributed

as small grains throughout the
amalgam without necessarily touching
, & all diffusion of metal atoms must
be through other phases or grain
boundaries
83

B.W.Darvell
In the long term the conversion of
1 to 1 may occur in the presence
of unreacted phase alloy
+ 1 1
84

B.W.Darvell
In the presence of excess Hg ( in
terms of reaction with Ag-Sn
phases),namely the decomposition of
Cu-Sn phases to give the phase
Cu7Hg6 (2 phase) occurs.
, (IN Presence of EXCESS
Hg) 2 + 2
85

B.W.Darvell
Added Cu
As >6% Cu - excessive expansion not

included in conventional
extra Cu (admixed alloy),the difficulty may

be avoided
86

B.W.Darvell
One such second alloy is eutectic
of Ag-Cu system;this corresponds to
composition 3Ag.2Cu
+ 1 + 2 + 1
The elimination of 2 phase

improved properties - compressive
strength.
87

B.W.Darvell
High copper admixed alloy
1. Ag3Sn + AgCu + Hg Ag2Hg3 + Sn8Hg +

Ag3Sn + AgCu
( ) (1 ) (2 )
( )
2. Sn8Hg + AgCu Cu6Sn5 + Ag2Hg3

+ Ag3Sn
(2) ( ) (1 )
( )
88

High copper
unicompositional alloy
Ag3Sn + Cu3Sn + Hg Cu6Sn5

+ Ag2Hg3
( ) () () 89
(1 )
Microstructure of Set Low Copper
Amalgam.
(Ag3Sn)
2(Sn8Hg)
Voids
1(Ag2Hg3)
90
Microstructure of Set High-Copper
Admixed Amalgam.
1(Ag2Hg3)
Eutectic(Ag3C
u2)
(Cu6Sn5)
(Ag3Sn)
91
Manufacture of alloy powder
Lathe cut alloy powder
92

B.W.Darvell
Spherical alloy powder
Produced by atomizing the molten alloy in a chamber
filled with an inert gas- argon
Molten metal falls through a distance of approximately

30 feet and cools
Results in characteristic spherical particle shapes.
If particles are allowed to cool before they contact the

surface of chamber, they are spherical in shape. If they
are allowed to cool on contact with the surface they are
flake shaped.
Particle size ranges form 5 to 40 microns 93

B.W.Darvell
A. Lathecut
alloy
B. Spherical
alloy 94
C.Dental
Phillips Science of Admixed
Materials;11 th
95

Temperatur
e
for Ag-Sn: if Cu if Zn
present: 465 present:
480 degree degree lower it
Celsius celsius further
The time of heat treatment may vary

depending on the temp. used & size of
ingot, but 24 hr at the selected temp.(350
to 450 C) is usual. 96

At the end of heat treatment:-
97

Particle(surface) treatment
98

The aging is related to relief of
stress in the particles during the
cutting of the ingot
(Phillips Science of Dental Materials;11th ed )
The alloy particles are aged by

subjecting them to a controlled
temperature of 60-100 degree
celsius for 1-6 hrs
(Craigs restorative dental materials,12th ed)
99
PARTICLE SIZE
100
Properties of amalgam
ANSI/ADA specification No.1 for

amalgam alloy contains certain
requirements:-
1. Maximum creep value of 3%
2. Minimum Compressive strength of 80 MPa at 1 hr when a

cylindrical specimen is compressed at a rate of
0.25mm/minute
3. Dimensional change between 5 min & 24 hrs after trituration, 101
should fall within a range of 20m/cm at 377 7C.

DIMENSIONAL CHANGES
102

dentistry;9th ed
103
20m 20m 20m 20m

High-Cu, admixed
High-Cu, single comp.
Low-Cu
104
If amalgam expanded during
hardening, leakage around the
margins of restorations would be
eliminated.
105
Shrinkage
when alloy & mercury are mixed ,contraction results as
particles begin to dissolve & 1 crystals grow
8Ag3Sn + 31Hg
(823.5ml/mol)=6Ag4Hg5 + Sn8Hg
(774.9ml/mol)
Thereby a decrease of 5.9% by

volume, or 2.0% by length (effect of
solidification of mercury) 106

dentistry;9th ed
Evidently the detrimental effect of
shrinkage occurs only when the amalgam
mass shrinks > 50 m.
107
LOSS OF GLOSS
Shrinkage due to reaction will
initially cause a decrease in the bulk
volume, but once contacts between
alloy particles or new crystals
interfere with this Hg will be
withdrawn into the mass, leaving
behind outline of the alloy particles.
108

dentistry;9th ed
The failure of any amalgam to provide a
marginal seal is due to the shrinkage of the
liquid mercury on reaction & surface
tension(a,b) 109

dentistry;9th ed
The surface thus produced clearly
cannot be in direct contact with the
cavity wall & a leakage path exists
which survives even if there is
subsequent expansion
110

dentistry;9th ed
The effect infact lead to loss of gloss -
frosted or sand blasted appearance.
Leakage path - surface tension of mercury
111
Materials science for dentistry;9th ed

B.W.Darvell
EXPANSION
crystal growth pressure

If sufficient Hg expansion occurs as a
result of growth of 1 crystals
112

dentistry;9th ed
DELAYED EXPANSION
113

dentistry;9th ed
Hydrogen is produced by electrolytic
action involving zinc & water
H2 doesnt combine with the amalgam

rather it collects within amalgam,
increasing internal pressure of
amalgam leading to expansion
114

dentistry;9th ed
Delayed expansion
115

dentistry;9th ed
STRENGTH
A)Compressive strength
)strongest in compression & much weaker
in tension & shear
)result function as a brittle material
116

amalga Compressive strength
(Mpa)
m
1 hr 7 days
Low copper 145 343

Admix 137 431
Single 262 510 117
composition
B) Tensile strength
cannot withstand high tensile or
bending stresses
amalgam Tensile strength
( Mpa)
Low copper 60
Admix 48
Single 64
composition 118

Factors affecting strength
1) Effect of trituration
-depends on the type of amalgam

alloy, the trituration time & the
speed of amalgamator
-either under or overtrituration

decreases the strength in both
traditional & high copper amalgams
119

2) Effect of mercury content
sufficient mercury
should be mixed with
the alloy to wet each
particle of the alloy
dry granular low mercury

high mercury contentmore
mixrough &
contentmore unreacted AgSn
pitted
2 phase particlesimpar
surfacecorrosion
ts strength to
restoration
120
3) Effect of
condensation
-good condensation techniques express
mercury & results in smaller volume
fraction of matrix phases
-in lathe cut alloys, higher condensation

pressure results in higher compressive
strength, particularly the early
strength(at 1 hr)
-on the other hand spherical amalgams

condensed with lighter pressures
produce adequate strength 121

4) Effect of porosity
-voids & porosities reduces strength
-porosity is caused by:-
a. decreased plasticity of the mix

(due to low Hg/alloy ratio, delayed
condensation, undertrituration)
b. inadequate condensation
pressure(results in inappropriate
adaptation at the margins & increase 122
number of voids)
c.irregularly shaped particles of alloy
powder
d. insertion of too large increments
-voids very less - with spherical

alloys
123
Phillips Science of Dental Materials;11th ed

5) Effect of rate of
hardening
-amalgams do not gain strength as

rapidly as might be desired
-at the end of 20min,compressive

strength may be only 6% of 1 wk
strength
-ADA stipulates a min of 80MPa at 1 hr

124

-the 1 hr compressive strength of
high Cu single composition
amalgams is relatively high
compared with admixed high Cu
amalgams
-patients should be cautioned not

to subject the restoration to high
bitting stresses for atleast 8 hrs
after placement ,by that time a
typical amalgam has reached at
least 70% of its strength
125

even after 6 months ,some
amalgams may still be
increasing in strength,
suggesting that the
reactions between matrix
phases & the alloy particles
may continue indefinitely
126

Strength of various phases
By studying the initiation &

propagation of crack in a set
amalgam strength studied
metallographical microscope
The propagation of the crack can be
halted & the specimen etched to
identify the various phases
127
CRAIGs Restorative Dental Materials;12th

Results of such studies have led to
the following ranking of different
phases of a set low copper amalgam
from strongest to weaker:
Ag3Sn(),silver-Hg phase(1),tin-
Hg phase(2) and the voids
In high copper amalgams, there is

preferential crack propagation
through the 1 phase & copper
containing particle
128

End of part 1
129
Thank you..
CREEP
Defined as time dependent strain or

deformation produced by stress(as
in Phillips)
Creep of dental amalgam is a slow

progressive permanent deformation of set
amalgam which occurs under constant
stress(static creep) or intermittent
stress(dynamic creep)
130

Creep is related to marginal breakdown
of low copper amalgams
Higher the creep, the greater is the

degree of marginal
deterioration(ditching)
131

According to ADA sp. No.1 creep
should be below 3%
creep values:-
-low copper amalgam:0.8-8%
-high copper amalgam:0.1-1%
132

spec. #1: creep rate < 3%
Creep rate has been found to correlate with
marginal breakdown of conventional low-copper
amalgams.
133
crostructure Vs. Creep
Low-Cu Larger volume Larger grain

fraction sizes
Presence of
High-copper amalgams have creep resistance:-

lack of gamma-2 phase.
(Cu6Sn5) embedded in
Single composition
spherical 1 grains and interlock
(Cu6Sn5) around Ag-Cu

Admixture
134
particles improves bonding to

Factors influencing creep:
High CREEP Low CREEP
Large 1 volume fraction

smaller 1 grain sizes
Larger 1 grain sizes
Phases of
amalgam
restorations
phase which act as
2 associated with high barrier to deformation of 1
creep rates. phase.
135
Materials science for dentistry;9t

B.W.Darvell0
Effect of manipulative
variables
For increased strength & low creep values:-
Mercury alloy ratio should be minimum
Condensation pressure should be maximum for lathe cut

or admixed alloys
Careful attention should be given towards timing of

trituration & condensation
136

Compressive % Creep Tensile Strength
Strength (MPa) (24 hrs) (MPa)
Amalgam Type 1 hr 7 days
Low Copper1 145 343 2.0 60
Admixture2 137 431 0.4 48
Single Composition3 262 510 0.13 64
1
Fine Cut,
Caulk 2
137
Dispersalloy,
Caulk
Phillips Science of Dental Materials 2003
3
Tytin, Kerr
MICROLEAKAGE OF AMALGAM
Poor condensation
The 2 to 20micron-
techniques -
wide gap
marginal voids
Lack of corrosion Coefficient of

by-products thermal expansion
Single-composition-spherical alloys which

leak more - do not adapt as well to the
margins 138
Penetration of fluids & debris around
the margins may cause secondary
caries
If the amalgam restoration is inserted

properly, leakage decreases as the
restoration ages in mouth due to the
corrosion products that forms in the
tooth-restoration interface
Thus amalgam is the self sealing 139
restoration Phillips Science of Dental Materials;11th

Both low & high copper amalgams
are capable of sealing against
microleakage but the accumulation
of corrosion products is slower with
the high copper alloys*
*Corrosion sealing of amalgam restorations -in

vitro study
Oper Dent. 2009 May-Jun;34(3):312-20.
140
The sealing ability of different types of
dental amalgams when used as retrograde
fillings with and without a cavity varnish
was studied.
Of the materials tested, a copper-

containing spherical amalgam gave the
best results.
Regardless of material used, the apical seal

was significantly improved when a varnish
was applied to the cavity prior to the
placement of the retrograde amalgam
filling
141
Journal of Endodontics
Volume 9, Issue 12, Pages 551-553, December 1983
THERMAL EXPANSION
AND CONDUCTIVITY
Thermal expansion Thermal conductivity
coefficient E 10-6 / C K 10-6 / C(mm2/s)
Amalgam 22-28 9.4

Composite resin 20-60 0.25
GIC 10-11 0.15-0.35
Tooth 11.4 0.18-0.47
E = volume expansion for unit rise in temperature

K = quantity of heat passing per s through a block of unit thickness
and cross sectional area for a temp. difference of 1C
142

CHEMICAL PROPERTIES
Dental amalgam restorations undergo both
chemical and electrochemical corrosion.
TARNISH AND CORROSION
Tarnish : is a surface discolouration on a metal or

even a slight loss or alteration of the surface
finish or luster.
Corrosion : is an actual deterioration of a metal by

reaction with its environment.
143

The degree of tarnish depends on :
i. The oral environment
ii. The type of alloy used
144

In dental practice , a limited amount of
corrosion around the margins of amalgam
restorations may be beneficial, since the
corrosion products tends to seal the
marginal gap & inhibit the ingress of
fluids & bacteria
But excessive corrosion can lead to

increased porosity, reduced marginal
integrity, loss of strength & the release of
metallic products into the oral
environment
145

Liberation of
corrosion products
GAP
146

Electrochemical measurements on
pure phases
Ag2Hg3(1)
(highest Ag3Sn() Ag3Cu2
corrosion
resistance)
Sn7-8Hg(2)
(least corrosion Cu6Sn5() Cu3Sn(),
resistance)
147

The p/o small amounts of tin,
silver & copper that may
dissolve in various amalgam
phases has a great influence on
their corrosion resistance
148

The higher content of tin ,
less the corrosion resistance
The tin content of the 1

phase is higher for low
copper alloys than for high
copper alloys
149

The p/o a relatively high %age of tin in low copper alloys
reduces the corrosion resistance of their 1 phase so its
lower than their phase
This is not true for high copper alloys
150

Chemical Corrosion :
Occurs most notably on the

occlusal surface and produces a
black amalgam silver tarnish film
Corrosion products are mainly

oxides and chlorides of tin.
151

Electrochemical corrosion
Chemically different sites act as anode or

cathode.
Electrolyte (saliva)
The anode corrodes, producing soluble and

insoluble reaction products.
Ag2Hg3 phase has the highest corrosion resistance, followed

by Ag3Sn, Ag-Cu, Cu3Sn, Cu6Sn5 and Sn7-8Hg.
152

LOW COPPER ALLOYS low
corrosion resistance
Most corrodible phase is tin-mercury or 2 phase
The average depth of corrosion for most

amalgam alloys is 100-500 m.
Even though, a relatively small portion (1- 13%)

of the amalgam mass consists of the 2 phase, in
an oral environment, the structure of such an
amalgam will contain a higher percentage of
corroded phase 153

The corrosion results in the formation of tin
oxychloride, from the tin in 2 and also
liberates Hg.
Sn7-8Hg + 1/202 + H2O + Cl- Sn4 (OH) 6 Cl2 + Hg
Tin oxychloride
Unreacted 1 and 2

( Mercuroscopic Expansion )
Additional l and 2 result in porosity and lower strength.

Additional l and 2 result in porosity and lower strength.
154

THE HIGH COPPER ADMIXED
AND UNICOMPOSITION ALLOY
No 2 phase in the final set mass.
The phase formed with high copper alloys is

not an interconnected phase such as the 2
phase, and it has better corrosion resistance.
phase is the least corrosion resistant phase in

high copper amalgam - corrosion product
CuCl2.3Cu (OH)2
Cu6Sn5 + 1/202 +H2O + Cl- CuCl2.3Cu (OH)2 + SnO.
155

Surface tarnish of low copper
amalgams is more associated with
than 1 phase, whereas in high
copper amalgams surface tarnish is
related to the copper rich phases, &
silver-copper eutectic
156

Galvanic corrosion
If dental amalgam is in direct contact with
an adjacent metallic restoration such as gold
crown, the dental amalgam is the anode in
the circuit.
Between titanium High copper dental Gallium direct

and direct filling amalgams when in filling alloys
alloys contact with Ti galvanic
Small galvanic little galvanic interaction
interaction corrosion more
detrimental
157
Dental Materials, Volume 15, Issue 5, September 1999, P

Crevice Corrosion:
Local electrochemical cells may
arise whenever a portion of
amalgam is covered by plaque on
soft tissue. It behaves anodically
and corrodes. If these occur in
cracks or crevice, it is called crevice
corrosion.
Stress Corrosion:
Regions that are under stress display a
greater probability for corrosion, thus resulting
in stress corrosion.
For occlusal dental amalgam greatest 158
combination of
159

Factors related to excess tarnish & corrosion
Surface
High residual texture-small
mercury scratches &
exposed voids
Contact of Moisture
dissimilar contamination
metals, eg. gold during
& amalgam condensation
Type of alloy-
low cu
alloy>high cu
alloy 160
CRAIGs Restorative Dental Materials;12th ed

Corrosion of amalgam can be
reduced by:-
Smoothening & polishing the restoration

Correct mercury/alloy ratio & proper manipulation
Avoid dissimilar metals including mixing of high & low
copper amalgams
161
Manipulation of
dental amalgam
162
How to select an alloy ??
Set Par
tin ticl
g e
tim siz
e
e Par
ticl
e Comp
osiitio
sh n
ap
e
Elimi
natio
n of
Zin
2 c 163
phase
Aim at High strength
achievi
ng Minimal dimensional change
Lowest creep
Good condensation
High corrosion resistance
Good finishing and polishing

164
Mercury alloy ratio
Earlier
excess Current
mercury minimum
mercury
165
Eames technique -
minimum mercury and
alloy 1:1 ratio
50 %
Lathe cut Spheri
cal 42
%
166
proportioning
Pre weighed
Manual Capsules (48 to
55%)
167
168
Equipment for hand mixing of alloy powder and Equipment for mixing of alloy pellets and
mercury in mortar and pestle using excess controlled mercury in reusable capsules
mercury.( 1900 to 1940 ) with mechanical mixing in amalgamator
(1940 to 1970 )
169
Capsules
Disposable Self activating Reusable Pre

proportioned
170
Size of mix
Single mix 400 mg
Single mix 600 mg
Double mix 800 mg
Amalgam core -
1200 mg
171
Trituration
Defined as process of grinding

powder, esp. within a liquid.
In dentistry, the term is used to
describe the process of mixing the
amalgam alloy particles with
mercury in an amalgamator
172
Objectives
To wet allot particles

Surface should be clean
Rubbing Removes oxide layer
173
Hand mixing
Mechanical mixing
174
Hand
Number of rotations
Speed of rotation
Magnitude of pressure 25 to
45 secs
175
Mechanical mixing
Amalgamator or trituration
Capsule mortar
Piston pestle
176
Amalgamators or triturators
SPEED TIME
ENERGY = Speed x Time

177
Coherence time ( Tc )
Minimum mixing time

required for formation of a
single coherent pellet
5 tc is ideal
178
Variations of mixing time
shape of Particles
Size of mix
179
Advantages of mechanical trituration
Efficient
Short time
Standardised
Less mercury
180
Variations of trituration
Under Normal Over

Soupy
Rough grainy Shiny
difficult to remove
May crumble Smooth & soft from capsule
Becomes hard Warm when Too plastic to
soon removed from manipulate
Excess mercury capsule Decreased working
time
Tarnish and Besty
compressive and Higher contraction
corrosion of amalgam
tensile strength
Low strength Increased creep
Increased tarnish
and corrosion Strength of lathe
cut alloys increased
resistance &
181
reduced for high
copper amalgam
Mulling
Continuation of trituration
Hand with rubber dam or
glove
Mechanical pestle free
capsule
Coherent, consistent and
homogenous mix 182
Condensation
To achieve greatest possible density

Sufficient mercury only remains
To enhance matrix phase
Should enhance
Adaptation to walls and margins
Homogenous bulk
Excess mercury removal
Minimum voids
183
Modes of condensation
Manual
Mechanical - pneumatic &
electrical
184
185
Technique of condensation
Absolute isolation
Small increments
3-4 lbs pressure on average
From smaller to larger condensers
Centre to walls
Overfill by 1 mm
remove excess mercury on surface
186
Lathe cut high mercury
greater forces and large
condensers
Spherical low mercury low
condensation pressure
187
Pre carving burnishing
Form of condensation
adaptation to margins
Burnishers - heavy strokes
larger condensers centre to
beyond margins
188
189
Carving
Only after attaining adequate strength

Scraping or ringing sound
Cleoid discoid , hollenbeck , wards ,
diamond carvers
Embrasures - triangular fossa remove
flash - inclined planes occlusal fosa
carved
Check centric occlusion
190
Mostly pulling strokes
Pushing strokes for occlusal
anatomy
70 to 90 degree angle to
preserve bulk at margins
Under carving grown out
appearance 191
Post carve burnishing
Light rubbing of carved surface with burnisher

Which improves
Smoothness and shiny appearance
Denser amalgam with more compaction
Sealing at margins
Both pre & post carve burnishing improve adaptation
192
Finishing and polishing
Refine anatomy ,contours and

marginal integrity
Resistance to tarnish and corrosion
24 hrs after restoration
Spherical high copper 8 to 12 hrs
193
Pumice mixed with tin oxide slurries is
used
Rubbere cup ,wheel , brush used

Temperature should be < 60o
194
Quality of dental amalgam
Manufacturer composition , heat

treatment , particle nature
Operator selection , mercury alloy
ratio, dispensing , trituration ,
restorative technique ,cavity design ,
marginal integrity , final finishing
195
Failure of amalgam restoration
Secondary / recurrent caries

Marginal fracture / marginal ditching
Bulk fracture of tooth or amalgam
Dimensional change
Tarnish and corrosion
Pain succeeding amalgam restoration
Proximal overhangs
Poor contouring / marginal ridge incompatibility
196
Reasons for failure
Improper case selection

Improper cavity preparation
Improper manipulation
Improper isolation
197
Removal of old amalgam restoration
Rubber dam
Charcoal and vacuum suction
Thorough patient protection and
operator protection
Newer burs recommended
Better to section and scoop out
198
199
Amalgam blues
200
Amalgam tattoo
201
Recent advances in dental amalgam
Bon
ded
Galli amal
um Low
Indiu merc gam
bas m
ury
contai
ed ning amal
allo alloy gam
powd
ys
Conso er & fluor
lidate binar ide
d y Hg
silver - In cont
alloy syste ainin
syste m g
m amal
gam
202
Gallium based alloys
Mendeleef in 1871
De boisbandran 1875
Putt kammer 1928 replacement
for Hg
203
Gallium
Liquid at room temperature

Lowered melting point with addition of
In and Sn
Trade names
Galloy
Bayswater
Gallium GF
Gallium GF II 204
Composition
Silver 60.5%
Tin 24.5%
Copper 12.3 %
Indium 2.7 %
Liquid
Gallium 65 %
Indium 19 %
Tin 16 %
205
Reaction
AgSn + Ga --------------------- AgGa

+ Sn
206
Properties
207
Advantages
Low creep
Adequate compressive strength
Polishing on same day possible
Good wear resistance
Heat resistant
Good marginal seal
208
Disadvantages
Excessive expansion post operative sensitivity

Difficult to manipulate
Instrument cleaning is difficult
Low corrosion resistance
High cost
209
Recent studies indicated
More corrosion permite Ga o

2 3 & tin oxide
More roughness than amalgam
Low edge strength
210
Consolidated silver alloy system
National institute of standards & technology

Silver alloy particles in dilute fluoro boric acid solution
Alloy surfaces are very clean
Similar to direct filling gold restoration
Strain hardening is needed
Excessive forces to achieve void free compaction
211
Indium containing alloy powder &
binary mercury indium liquid alloy
Powell et al in 1989 indium to alloy and mercury

Reduced mercury release
Indium oxide and tin oxide
Indisperse and indilloy
Less cytotoxic than original
Increased strength
Less mercury needed
Low creep value
212
Fluoride containing amalgam
Innes & youndelis in 1966 , serman in 1970 , stone in 1971

Possible mechanisms are
Dissolution of salt crystals in contact with materials
Through corrosion products fluoralloy
Slow releasing device
213
Clust summall phaseall
Minimax
Aristoloy
oy oy CR
er
214
CuF InF SnF CaF
2
2 3 2
215
Low mercury amalgam
Alloy particles are pre condensed by manufacturer

Requires less mercury
216
Bonded amalgams
Baldwin technique amalgam on zinc phosphate cement

GIC and polycarboxylate were tried
4 META ,10 MDP ,BIS GMA was tried recently
Based on dentin bonding system of nakabayashi
Bond strength upto 12 to 15 Mpa can be achieved
Spherical - bond strength more than admix
Longevity is not enhanced
217
C & B METABOND
PANAVIA 21
ALL BOND 2
SCOTCH BOND
MULTIPURPOSE
AMALGABOND
PLUS
Bonding procedure
Excess Thin film of

Self etching
primer adhesive
primer
removed resin placed
Amalgam
Finishing & Anaerobic placed
Polishing adhesives directly onto
unset resin
218
219
Indications
Auxiliary retention &

reinforcement
Improvement of marginal seal
necessary
Posterior teeth extensive caries
Low gingivo occlusal height
Core for cast crowns 220
Advantages
More conservative preparation

Reinforce tooth
Minimize microleakage
Low Incidence of marginal fracture
Cost effective
221
Disadvantages
Highly technique sensitive

Reduced mechanical
properties
Questionable hydrolytic bond
stability
Longterm results not
confirmed yet 222
Mercury considerations
Mercurodontics ??
223
Mercury A Global Issue
Mercury distribution
and exposure is a
global problem
Side effects of mercury
Allergy
Toxicity
225
Types of mercury
Inorganic Organic
Elemental
mercury mercury
Dental Mercury salts Methyl
Pure Mercuric mercury
Dermal or chloride , More potent
inhalational iodide and bio
Long-term ,cinnabar accumulative
exposure or Corrosive Humans are
one large Hepatic primarily
exposure damage exposed
Folk
medicine
Skin irritation 226
staining
Normal daily intake of mercury
15 micro.g from food

1 micro.g from air
0.4 micro.g from water
227
228
Mercury released during manipulation
229
TLV at 8 hours/day or 40 hours /week
O.o5 mg / m 3
(much lower concentration in dental
office )
maximum limit in urine and saliva 0.15 mg / lt
maximum limir in blood is o.30 mg/lt
230
Toxic reactions of mercury
Microgra
ms /kg Reactions
body wt
3 to 7 Lowest dose to elicit
100 Decreased brain activity & verbal
skills
500 Paraesthesia, irritability , depression
,tremors
1000 Ataxia, kidney inflammation, swollen
gums,
Excessive tremors
2000 Joint pain
4000 Hearing loss & death 231
Minamata disease (1952)
232
Mercury hygiene considerations
While manipulating
While restoring
While removing
233
Amalgam Separator
Technologies on the Market
Sedimentation
Filtration
Chemical filtration (e.g., chelation)
Centrifuging
Combination of above technologies
Typical Amalgam Separator Installation
Locations
1= inline, chairside
2= inline, central,
before separator Dental operatories
3= outlet side, air
Air water separator
Exhaust
Basement 2a Dry system

or utility 1
closet
Wet system
2
3 Wastewater
to sewer
Vacuum
pump
Air water separator
Present amalgam status
237
Future????????
238
To conclude
239
Thank you..
240

Dental Amalgam

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Dental Amalgam

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Good morning..

Current status of amalgam

PHILLIPS Science of Dental Materials;11th ed

American Dental Association (ADA) Council on Scientific Affairs,

Biomaterials, Volume 18, Issue 13, July 1997, Pages 939-946 5

Eichmiller FC: Research into Non-Mercury Containing Metallic

Ronald K Harris: Dental Amalgam: Success Or Failure?. Op

Dunne SM et al: Current materials and Techniques for direct

A dental restoration for

Dentalamalgam: Anupdate Conserv Dent.2010 Oct;13(4

Dentalamalgam: Anupdate Conserv Dent.2010 Oct;13(4

Reduced Early seal

But development of alternatives based on ceramics

Source: Websters New World Dictionary of the American

Sturdevants Art & Science of Operative

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

In 1818, Louis Nicolas Regnart, a

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

ADA specification No 1 was adapted for

J Conserv Dent.2010 Oct;13(4):

Greener EH. Amalgam-yesterday, today and tomorrow.Oper

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

J Conserv Dent.2010 Oct;13(4):

AMALGAM USE DECLINED

Dr. Christopher S. Brewster (1846) - condemned the use

The amalgam controversy-an evidence

1844 - the societys members were warned

The amalgam controversy-an evidence

In 1858, Townsend reversed his stance

IN 1883, DR. ALTON H. THOMPSON COMMENTED

The presence of amalgam with us is a tremendous

The amalgam controversy-an evidence

based analysis ; JADA,Vol.132,march 2001

The amalgam controversy-an evidence

Controversy over amalgam use surfaced

The amalgam controversy-an evidence

The amalgam controversy-an evidence

The amalgam controversy-an evidence

Materials used in dentistry 1st edition

It was the Neurobiologist Mats Hanson,

The amalgam controversy-an evidence

The amalgam controversy-an evidence

The amalgam controversy-an evidence

May 13- 1997

Materials used in dentistry 1 edition

The amalgam war continues to

The amalgam controversy-an evidence

The amalgam controversy-an evidence

The amalgam controversy-an evidence

based on available scientific

"There currently appears to be no

American Dental Association (ADA) Council on

American Dental Association (ADA) Council on

American Dental Association (ADA) Council on

American Dental Association (ADA) Council on

Sturdevants Art & Science of Operative

Sturdevants Art & Science of Operative

Lathe cut Spherical

Low copper High copper