Amalgam

59
Dental Amalgam Dental Amalgam Col Kraig S. Vandewalle USAF Dental Evaluation & Consultation Service

Transcript of Amalgam

Page 1: Amalgam

Dental AmalgamDental Amalgam

Col Kraig S VandewalleUSAF Dental Evaluation amp Consultation Service

Official Disclaimer

bull The opinions expressed in this presentation are

those of the author and do not necessarily

reflect the official position of the US Air Force or

the Department of Defense (DOD)

bull Devices or materials appearing in this

presentation are used as examples of currently

available productstechnologies and do not

imply an endorsement by the author andor the

USAFDOD

Overview

bull History

bull Basic composition

bull Basic setting reactions

bull Classifications

bull Manufacturing

bull Variables in amalgam

performanceClick here for briefing on dental amalgam (PDF)

History

bull 1833

ndash Crawcour brothers introduceamalgam to US

bull powdered silver coins mixed with mercuryndash expanded on setting

bull 1895

ndash GV Black develops formula for modern amalgam alloy

bull 67 silver 27 tin 5 copper 1 zincndash overcame expansion problems

History

bull 1960rsquos

ndash conventional low-copper lathe-cut alloys

bull smaller particles

ndash first generation high-copper alloys

bull Dispersalloy (Caulk)

ndash admixture of spherical Ag-Cu

eutectic particles with

conventional lathe-cut

ndash eliminated gamma-2 phase

Mahler J Dent Res 1997

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 2: Amalgam

Official Disclaimer

bull The opinions expressed in this presentation are

those of the author and do not necessarily

reflect the official position of the US Air Force or

the Department of Defense (DOD)

bull Devices or materials appearing in this

presentation are used as examples of currently

available productstechnologies and do not

imply an endorsement by the author andor the

USAFDOD

Overview

bull History

bull Basic composition

bull Basic setting reactions

bull Classifications

bull Manufacturing

bull Variables in amalgam

performanceClick here for briefing on dental amalgam (PDF)

History

bull 1833

ndash Crawcour brothers introduceamalgam to US

bull powdered silver coins mixed with mercuryndash expanded on setting

bull 1895

ndash GV Black develops formula for modern amalgam alloy

bull 67 silver 27 tin 5 copper 1 zincndash overcame expansion problems

History

bull 1960rsquos

ndash conventional low-copper lathe-cut alloys

bull smaller particles

ndash first generation high-copper alloys

bull Dispersalloy (Caulk)

ndash admixture of spherical Ag-Cu

eutectic particles with

conventional lathe-cut

ndash eliminated gamma-2 phase

Mahler J Dent Res 1997

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 3: Amalgam

Overview

bull History

bull Basic composition

bull Basic setting reactions

bull Classifications

bull Manufacturing

bull Variables in amalgam

performanceClick here for briefing on dental amalgam (PDF)

History

bull 1833

ndash Crawcour brothers introduceamalgam to US

bull powdered silver coins mixed with mercuryndash expanded on setting

bull 1895

ndash GV Black develops formula for modern amalgam alloy

bull 67 silver 27 tin 5 copper 1 zincndash overcame expansion problems

History

bull 1960rsquos

ndash conventional low-copper lathe-cut alloys

bull smaller particles

ndash first generation high-copper alloys

bull Dispersalloy (Caulk)

ndash admixture of spherical Ag-Cu

eutectic particles with

conventional lathe-cut

ndash eliminated gamma-2 phase

Mahler J Dent Res 1997

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 4: Amalgam

History

bull 1833

ndash Crawcour brothers introduceamalgam to US

bull powdered silver coins mixed with mercuryndash expanded on setting

bull 1895

ndash GV Black develops formula for modern amalgam alloy

bull 67 silver 27 tin 5 copper 1 zincndash overcame expansion problems

History

bull 1960rsquos

ndash conventional low-copper lathe-cut alloys

bull smaller particles

ndash first generation high-copper alloys

bull Dispersalloy (Caulk)

ndash admixture of spherical Ag-Cu

eutectic particles with

conventional lathe-cut

ndash eliminated gamma-2 phase

Mahler J Dent Res 1997

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 5: Amalgam

History

bull 1960rsquos

ndash conventional low-copper lathe-cut alloys

bull smaller particles

ndash first generation high-copper alloys

bull Dispersalloy (Caulk)

ndash admixture of spherical Ag-Cu

eutectic particles with

conventional lathe-cut

ndash eliminated gamma-2 phase

Mahler J Dent Res 1997

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 6: Amalgam

Historybull 1970rsquos

ndash first single composition sphericalbull Tytin (Kerr)

bull ternary system (silvertincopper)

bull 1980rsquos

ndash alloys similar to Dispersalloy and Tytin

bull 1990rsquos

ndash mercury-free alloys

Mahler J Dent Res 1997

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 7: Amalgam

Amalgam

bull An alloy of mercury with another metal

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 8: Amalgam

Why Amalgam

bull Inexpensive

bull Ease of use

bull Proven track record

ndash gt100 years

bull Familiarity

bull Resin-free

ndash less allergies than composite

Click here for Talking Paper on Amalgam Safety (PDF)

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 9: Amalgam

Constituents in Amalgam

bull Basic

ndash Silver

ndash Tin

ndash Copper

ndash Mercury

bull Other

ndash Zinc

ndash Indium

ndash Palladium

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 10: Amalgam

Basic Constituents

bull Silver (Ag)

ndash increases strength

ndash increases expansion

bull Tin (Sn)

ndash decreases expansion

ndash decreased strength

ndash increases setting time

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 11: Amalgam

Basic Constituents

bull Copper (Cu)

ndash ties up tin

bull reducing gamma-2 formation

ndash increases strength

ndash reduces tarnish and corrosion

ndash reduces creep

bull reduces marginal deterioration

Philliprsquos Science of Dental Materials 2003

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 12: Amalgam

Basic Constituents

bull Mercury (Hg)

ndash activates reaction

ndash only pure metal that is liquid at room temperature

ndash spherical alloysbull require less mercury

ndash smaller surface area easier to wet

raquo 40 to 45 Hg

ndash admixed alloysbull require more mercury

ndash lathe-cut particles more difficult to wet

raquo 45 to 50 Hg

Click here for ADA Mercury

Hygiene Recommendations

Philliprsquos Science of Dental Materials 2003

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 13: Amalgam

Other Constituents

bull Zinc (Zn)

ndash used in manufacturingbull decreases oxidation of other elements

ndash sacrificial anode

ndash provides better clinical performancebull less marginal breakdown

ndash Osborne JW Am J Dent 1992

ndash causes delayed expansion with low Cu alloysbull if contaminated with moisture during condensation

ndash Phillips RW JADA 1954

Philliprsquos Science of Dental Materials 2003

H2O + Zn ZnO + H2

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 14: Amalgam

Other Constituents

bull Indium (In)

ndash decreases surface tensionbull reduces amount of mercury necessary

bull reduces emitted mercury vapor

ndash reduces creep and marginal breakdown

ndash increases strength

ndash must be used in admixed alloys

ndash examplebull Indisperse (Indisperse Distributing Company)

ndash 5 indium

Powell J Dent Res 1989

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 15: Amalgam

Other Constituents

bull Palladium (Pd)

ndash reduced corrosion

ndash greater luster

ndash example

bull Valiant PhD (Ivoclar Vivadent)

ndash 05 palladium

Mahler J Dent Res 1990

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 16: Amalgam

Basic Compositionbull A silver-mercury matrix containing filler

particles of silver-tin

bull Filler (bricks)ndash Ag3Sn called gamma

bull can be in various shapes

ndash irregular (lathe-cut) sphericalor a combination

bull Matrixndash Ag2Hg3 called gamma 1

bull cement

ndash Sn8Hg called gamma 2 bull voids

Philliprsquos Science of Dental Materials 2003

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 17: Amalgam

Basic Setting Reactions

bull Conventional low-copper alloys

bull Admixed high-copper alloys

bull Single composition high-copper alloys

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 18: Amalgam

bull Dissolution and precipitation

bull Hg dissolves Ag and Snfrom alloy

bull Intermetallic compoundsformed

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

(Hg)

Ag

AgAg

Sn

Sn

Sn

Conventional Low-Copper Alloys

Hg Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 19: Amalgam

Conventional Low-Copper Alloys

bull Gamma ( ) = Ag3Sn

ndash unreacted alloy

ndash strongest phase and

corrodes the least

ndash forms 30 of volume

of set amalgam

Ag-Sn

Alloy

Ag-Sn

Alloy

Ag-Sn Alloy

Mercury

Ag

AgAg

Sn

Sn

Sn

Hg

Hg

Hg

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 20: Amalgam

Conventional Low-Copper Alloys

bull Gamma 1 ( 1) = Ag2Hg3

ndash matrix for unreacted alloy

and 2nd strongest phase

ndash 10 micron grains

binding gamma ( )

ndash 60 of volume

1

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 21: Amalgam

Conventional Low-Copper Alloys

bull Gamma 2 ( 2) = Sn8Hg

ndash weakest and softest phase

ndash corrodes fast voids form

ndash corrosion yields Hg which

reacts with more gamma ( )

ndash 10 of volume

ndash volume decreases with time

due to corrosion

AgAg33Sn + HgSn + Hg AgAg33Sn + AgSn + Ag22HgHg33 + Sn+ Sn88HgHg

Philliprsquos Science of Dental Materials 2003

1 2

2

Ag-Sn Alloy

Ag-Sn

Alloy

Ag-Sn

Alloy

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 22: Amalgam

Admixed High-Copper Alloys

bull Ag enters Hg from Ag-Cu spherical eutectic particlesndash eutectic

bull an alloy in which the elements are completely soluble in liquid solution but separate into distinct areas upon solidification

bull Both Ag and Sn enter Hg from Ag3Sn particles

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Ag-Sn

Alloy

Ag-Sn

AlloyMercury

Ag

AgAg

SnSn

Ag-Cu Alloy

AgHgHg

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 23: Amalgam

Admixed High-Copper Alloys

bull Sn diffuses to surface of

Ag-Cu particles

ndash reacts with Cu to form

(eta) Cu6Sn5 ( )

bull around unconsumed

Ag-Cu particles

Ag-Sn

Alloy

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 24: Amalgam

Admixed High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3)

surrounds ( ) eta phase

(Cu6Sn5) and gamma ( )

alloy particles (Ag3Sn)Ag-Sn

Alloy

1

Ag-Cu Alloy

Ag-Sn

Alloy

Philliprsquos Science of Dental Materials 2003

AgAg33Sn + AgSn + Ag--Cu + HgCu + Hg AgAg33Sn + AgSn + Ag--Cu + AgCu + Ag22HgHg33 + Cu+ Cu66SnSn55

1

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 25: Amalgam

Single Composition

High-Copper Alloys

bull Gamma sphere ( ) (Ag3Sn)

with epsilon coating ( )(Cu3Sn)

bull Ag and Sn dissolve in Hg

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

Mercury (Hg)

Ag

Sn

Ag

Sn

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 26: Amalgam

Single Composition

High-Copper Alloys

bull Gamma 1 ( 1) (Ag2Hg3) crystalsgrow binding together partially-

dissolved gamma ( ) alloyparticles (Ag3Sn)

bull Epsilon ( ) (Cu3Sn) develops crystals on surface of gamma particle (Ag3Sn)

in the form of eta ( ) (Cu6Sn5)

ndash reduces creep

ndash prevents gamma-2 formation

Ag-Sn Alloy

Ag-Sn Alloy

Ag-Sn Alloy

1

AgAg33Sn + CuSn + Cu33Sn + HgSn + Hg AgAg33Sn + CuSn + Cu33Sn + AgSn + Ag22HgHg33 + Cu+ Cu66SnSn55

Philliprsquos Science of Dental Materials 2003

1

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 27: Amalgam

Classifications

bull Based on copper content

bull Based on particle shape

bull Based on method of adding

copper

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 28: Amalgam

Copper Content

bull Low-copper alloys

ndash 4 to 6 Cu

bull High-copper alloys

ndash thought that 6 Cu was maximum amount

bull due to fear of excessive corrosion and expansion

ndash Now contain 9 to 30 Cu

bull at expense of Ag

Philliprsquos Science of Dental Materials 2003

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 29: Amalgam

Particle Shape

bull Lathe cut

ndash low Cu

bull New True

Dentalloy

ndash high Cu

bull ANA 2000

bull Admixture

ndash high Cu

bull Dispersalloy Valiant

PhD

bull Spherical

ndash low Cu

bull Cavex SF

ndash high Cu

bull Tytin Valiant

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 30: Amalgam

Method of Adding Copper

bull Single Composition Lathe-Cut (SCL)

bull Single Composition Spherical (SCS)

bull Admixture Lathe-cut + Spherical Eutectic (ALE)

bull Admixture Lathe-cut + Single Composition

Spherical (ALSCS)

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 31: Amalgam

Single Composition Lathe-Cut

(SCL)

bull More Hg needed than spherical alloys

bull High condensation force needed due to

lathe cut

bull 20 Cu

bull Example

ndash ANA 2000 (Nordiska Dental)

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 32: Amalgam

Single Composition Spherical

(SCS)bull Spherical particles wet easier with Hg

ndash less Hg needed (42)

bull Less condensation force larger condenser

bull Gamma particles as 20 micron spheres

ndash with epsilon layer on surface

bull Examples

ndash Tytin (Kerr)

ndash Valiant (Ivoclar Vivadent)

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 33: Amalgam

Admixture

Lathe-cut + Spherical Eutectic

(ALE)bull Composition

ndash 23 conventional lathe cut (3 Cu)

ndash 13 high Cu spherical eutectic (28 Cu)

ndash overall 12 Cu 1 Zn

bull Initial reaction produces gamma 2

ndash no gamma 2 within two years

bull Example

ndash Dispersalloy (Caulk)

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 34: Amalgam

Admixture

Lathe-cut + Single Composition

Spherical (ALSCS)bull High Cu in both lathe-cut and spherical

components

ndash 19 Cu

bull Epsilon layer forms on both components

bull 05 palladium added

ndash reinforce grain boundaries on gamma 1

bull Example

ndash Valiant PhD (Ivoclar Vivadent)

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 35: Amalgam

Manufacturing Process

bull Lathe-cut alloys

ndash Ag amp Sn melted together

ndash alloy cooled

bull phases solidify

ndash heat treat

bull 400 ordmC for 8 hours

ndash grind then mill to 25 - 50 microns

ndash heat treat to release stresses of grinding

Philliprsquos Science of Dental Materials 2003

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 36: Amalgam

Manufacturing Process

bull Spherical alloys

ndash melt alloy

ndash atomize

bull spheres form as particles cool

ndash sizes range from 5 - 40 microns

bull variety improves condensability

Philliprsquos Science of Dental Materials 2003

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 37: Amalgam

Material-Related Variables

bull Dimensional change

bull Strength

bull Corrosion

bull Creep

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 38: Amalgam

Dimensional Change

bull Most high-copper amalgams undergo a

net contraction

bull Contraction leaves marginal gap

ndash initial leakage

bull post-operative sensitivity

ndash reduced with corrosion over time

Philliprsquos Science of Dental Materials 2003

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 39: Amalgam

Dimensional Change

bull Net contraction

ndash type of alloybull spherical alloys have more

contractionndash less mercury

ndash condensation techniquebull greater condensation = higher contraction

ndash trituration timebull overtrituration causes higher contraction

Philliprsquos Science of Dental Materials 2003

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 40: Amalgam

Strength

bull Develops slowly

ndash 1 hr 40 to 60 of maximum

ndash 24 hrs 90 of maximum

bull Spherical alloys strengthen faster

ndash require less mercury

bull Higher compressive vs tensile strength

bull Weak in thin sections

ndash unsupported edges fracture

Philliprsquos Science of Dental Materials 2003

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 41: Amalgam

Corrosion

bull Reduces strength

bull Seals margins

ndash low copper bull 6 months

ndash SnO2 SnCl

ndash gamma-2 phase

ndash high copperbull 6 - 24 months

ndash SnO2 SnCl CuCl

ndash eta-phase (Cu6Sn5)

Sutow J Dent Res 1991

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 42: Amalgam

Creep

bull Slow deformation of amalgam placed under a constant load

ndash load less than that necessary to produce fracture

bull Gamma 2 dramatically affects creep rate

ndash slow strain rates produces plastic deformationbull allows gamma-1 grains to slide

bull Correlates with marginal breakdown

Philliprsquos Science of Dental Materials 2003

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 43: Amalgam

Creep

bull High-copper amalgams have creep resistance

ndash prevention of gamma-2 phasebull requires gt12 Cu total

ndash single composition sphericalbull eta (Cu6Sn5) embedded in gamma-1 grains

ndash interlock

ndash admixturebull eta (Cu6Sn5) around Ag-Cu particles

ndash improves bonding to gamma 1

Click here for table of creep values

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 44: Amalgam

Dentist-Controlled Variables

bull Manipulation

ndash trituration

ndash condensation

ndash burnishing

ndash polishing

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 45: Amalgam

Triturationbull Mixing time

ndash refer to manufacturerrecommendations

bull Click here for details

bull Overtriturationndash ldquohotrdquo mix

bull sticks to capsule

ndash decreases working setting time

ndash slight increase in setting contraction

bull Undertriturationndash grainy crumbly mix

Philliprsquos Science of Dental Materials 2003

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 46: Amalgam

Condensation

bull Forces

ndash lathe-cut alloysbull small condensers

bull high force

ndash spherical alloysbull large condensers

bull less sensitive to amount of force

bull vertical lateral with vibratory motion

ndash admixture alloysbull intermediate handling between lathe-cut and spherical

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 47: Amalgam

Burnishing

bull Pre-carve

ndash removes excess mercury

ndash improves margin adaptation

bull Post-carve

ndash improves smoothness

bull Combined

ndash less leakage

Ben-Amar Dent Mater 1987

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 48: Amalgam

Early Finishing

bull After initial set

ndash prophy cup with pumice

ndash provides initial smoothness to restorations

ndash recommended for spherical amalgams

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 49: Amalgam

Polishing

bull Increased smoothness

bull Decreased plaque retention

bull Decreased corrosion

bull Clinically effective

ndash no improvement in marginal integrity

bull Mayhew Oper Dent 1986

bull Collins J Dent 1992

ndash Click here for abstract

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 50: Amalgam

Alloy Selection

bull Handling characteristics

bull Mechanical and physical

properties

bull Clinical performance

Click here for more details

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 51: Amalgam

Handling Characteristics

bull Spherical

ndash advantagesbull easier to condense

ndash around pins

bull hardens rapidly

bull smoother polish

ndash disadvantagesbull difficult to achieve tight contacts

bull higher tendency for overhangs

Philliprsquos Science of Dental Materials 2003

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 52: Amalgam

Handling Characteristics

bull Admixed

ndash advantages

bull easy to achieve tight contacts

bull good polish

ndash disadvantages

bull hardens slowly

ndash lower early strength

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 53: Amalgam

Amalgam Properties

Compressive

Strength (MPa)

Creep Tensile Strength

(24 hrs) (MPa)

Amalgam Type 1 hr 7 days

Low Copper1 145 343 20 60

Admixture2 137 431 04 48

Single

Composition3

262 510 013 64

Philliprsquos Science of Dental Materials 2003

1Fine Cut Caulk 2 Dispersalloy Caulk 3Tytin Kerr

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 54: Amalgam

Survey of Practice TypesCivilian General Dentists

68

32

Amalgam

Users

Amalgam

Free

Haj-Ali Gen Dent 2005

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 55: Amalgam

Frequency of Posterior Materialsby Practice Type

39

51

3 7

Amalgam Direct Composite Indirect Composite Other

3

77

8

12

Amalgam Users

Amalgam Free

Haj-Ali Gen Dent 2005

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 56: Amalgam

Profile of Amalgam UsersCivilian Practitioners

78

22

Do you use amalgam in

your practice

Yes

No

DPR 2005

88

12

Do you place fewer amalgams

than 5 years ago

Yes

No

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 57: Amalgam

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

0

2

4

6

8

Amalgam Direct

Comp

Comp

Inlays

Ceramic

Inlays

CADCAM

Inlays

Gold

Inlays amp

Onlays

GI

Longitudinal Cross-Sectional

Hickel J Adhes Dent 2001

Annual Failure

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 58: Amalgam

0

5

10

15

Amalga

m

Direct

Com

p

Compo

mer

Comp

Inlays

Ceram

ic In

lays

CADCAM

Cast G

old G

I

Tunn

elART

Annual Failure

Manhart Oper Dent 2004

Click here for abstract

Standard Deviation

Longitudinal and Cross-Sectional Data

Review of Clinical Studies(Failure Rates in Posterior Permanent Teeth)

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil

Page 59: Amalgam

Acknowledgements

bull Dr David Charlton

bull Dr Charles Hermesch

bull Col Salvador Flores

QuestionsComments

Col Kraig Vandewalle

ndash DSN 792-7670

ndash ksvandewallenidbrmednavymil