Amalgam Notes – Compiled by Dr Danesh Kumar -JSMU

• Dental amalgam is a dental filling material used to restore the cavities. For
more than 150 years, dental amalgam has served as a safe, durable and
affordable material in restorative dentistry.
• Alloy-Alloy is a union of two or more metals.
• Amalgam--- Amalgam is an alloy of mercury with any other metal.
• Dental Amalgam ---Dental amalgam is an alloy of mercury with silver, tin,
and varying amounts of copper, zinc, and other minor constituents.
• Dental Amalgam Alloys---Dental amalgam alloys are silver-tin alloys with
varyin amounts of copper, zinc, and other metals.
Classification
1. Based on Shape of Particles
• i. Irregular: In this, shape of particles is irregular, and may be in the shape of
spindles or shavings.
• ii. Spherical: In this, shape of particle is spherical with smooth surface.
• iii. Spheroidal: In this, shape of particle is spheroidal with irregular surface.
2. Based on Copper Content
• i. Low copper alloy: Contains copper in range of 2 to 6%.
• ii. High copper alloy: Contains copper in the range of 12 to 30%.
3. Based on Zinc Content
• i. Zinc-containing alloys: In these, zinc is in range of 0.01–1%.
• ii. Zinc-free alloys: Contain less than 0.01% of Zinc.
4. Based on the Presence of Alloyed Metals
• i. Binary alloys: Contain two metals, i.e. silver and tin.
• ii. Ternary alloys: Contain three metals, i.e. silver, tin,and copper.
• iii. Quaternary alloys: Contain four metals, i.e. silver, tin, copper, and
zinc.Out of these, quaternary alloys are most acceptable.
5. Based on Whether Alloy is Unicompositional or Admixed
• i. single composition or unicompositional: each particle of alloy has same
chemical composition
• ii. Admixed alloys: these are physical blend of lathe-cut and spherical
particles.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 1

COMPOSITION
• Amalgam consists of amalgam alloy and mercury.
• Amalgam alloy is composed of silver-tin alloy with varying amounts of
copper, zinc, indium, and palladium. Dental amalgam alloys are mainly of
two types, low copper and high copper alloys.

• In general, amalgam alloy consists of silver 40% (minimum), tin 32%

(maximum), copper 30% (maximum), zinc 2% (maximum), and traces of
indium or palladium.
• In preamalgamated alloys, 3% mercury is used, which reacts more rapidly
when mixed with silver-tin alloy.
• Mercury used for dental amalgam is purified by distillation.
Effects of Constituent Metals on Properties of Amalgam
Silver: It has following effects on the properties of amalgam:
◆ Increases strength
◆ Increases setting expansion
◆ Reduces setting time
◆ Resists tarnish and corrosion
◆ Decreases flow
◆ Gives silver color to amalgam.
Tin: Tin helps in formation of a silver/tin compound (Ag/Sn). This is the gamma-
phase, which readily undergoes an amalgamation reaction with mercury. Tin
causes following effects:
◆ Increases setting time
◆ Retards the reaction
◆ Reduces strength, hardness, and setting expansion.
Copper: It has the following effects on the properties of amalgam:
◆ Reduces tarnish and corrosion
◆ Reduces creep
◆ Strengthening effect on the set amalgam

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 2

◆ Helps in uniform comminution of the alloy.
Zinc: Its presence is not essential. It may vary from 0% to 2 % by weight. It has the
following effects on the properties of amalgam:
◆ Scavenges the available oxygen to impede oxidization of Ag, Sn or Cu during
alloy ingot manufacturing.
◆ If zinc-containing alloys are contaminated with moisture, zinc gives rise to
delayed or secondary expansion.
Palladium (0–1% by weight): Improves the corrosion resistance and the
mechanical properties.
Indium (0–4% by weight): It decreases the evaporation of mercury and the
amount of mercury required to wet the alloy particles.
TYPES
• Lathe-cut is made by cutting of alloy from a pre-homogenized ingot, which
was heat treated at 420°C for many hours. Fillings are then reheated at
100°C for 1 hour for aging of the alloy.
• Spherical (spheroidal) alloy is formed when molten alloy is sprayed into a
column filled with inert gas; this molten metal solidifies as fine droplets

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 3

PHYSICAL PROPERTIES
1)Dimensional Change
• Small amount of contraction occurs in first half an hour after trituration
because mercury diffuses into silver and tin, and the mix dissolves in the

mercury. After this, expansion occurs because of crystallization of new

phases.
2)Mercuroscopic Expansion
• The term was given by Jorgenson. Expansion that occurs due to reaction of
mercury with alloy components is called as mercuroscopic expansion or
primary expansion. It is seen only in low copper amalgam.
• Mechanism: Release of mercury from g2 phase during electrochemical
corrosion results in additional formation of phase on reaction with
unreacted g phase, causing further expansion.
Causes:
◆ Increased Hg:alloy ratio
◆ Failure to squeeze out excess Hg
◆ Inadequate condensation pressure.
Consequences of Mercuroscopic Expansion:
◆ It results in “ragged” edges forming small unsupported ledges of
amalgam which can fracture during function.
3)Compressive Strength
• Strength of amalgam takes 24 hours to reach maximum. In the 1st hour,
only 40–60% of its maximum compressive strength is achieved.
• Compressive strength of amalgam is seven times more than its tensile or
shear strength making it brittle material. Being a brittle material, it is weak
in thin sections, thus unsupported edges of restoration fracture frequently.
To avoid this, a 90° butt joint angle of amalgam is required at the margins.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 4

Factors affecting strength:
◆ Mercury is weakest phase; more is residual mercury, weaker is the amalgam.
◆ Optimally done trituration increases strength
◆ More condensation force removes excess mercury, thus improves strength
◆ Presence of porosity decreases strength
◆ Smaller is the particle size of alloy powder, more is the strength
◆ Corrosion causes decrease in strength.
4)Plastic Deformation (Creep)
◆Creep is time-dependent response of an already set material to stress in form of
plastic deformation.
◆ It can be of two types depending on the stresses involved, viz static and
dynamic.
◆ By ADA specification number 1, creep is limited to 3% in set amalgam.
◆ Creep occurs near melting temperature of a material. In amalgam, creep occurs
because gamma-1 is a fine grained structure in which particles “slide” over each
other resulting in slipping of grain boundaries.
◆ Creep is undesirable because it causes amalgam to flow out over the margins
resulting in marginal deterioration and fracture.
Factors Affecting Creep:
◆ Low copper alloys have higher creep than high copper alloys because in high
copper alloys, copper binds with tin-forming eta-phase, this prevents formation
of g2-phase. Crystals of e-phase interlock and prevent slippage at gamma-1 grain
boundaries, resulting in less creep.
◆ Residual mercury is directly proportional to creep.
◆ Increased condensation pressure reduces creep because it reduces residual
mercury level.
5) Tarnish and Corrosion
• Tarnish is the surface discoloration of metal or alteration of surface finish.
• Corrosion is actual deterioration of a metal by reaction with its
environment. Corrosion proceeds from outer surface to interior of
restoration making it porous and spongy, thus it causes decrease in
strength of restoration by 50%. advantage of corrosion is that, its by-
products seal the preparation margin, resulting in self-sealing of amalgam.
• In both high and low copper amalgams, corrosion products are oxides and
chlorides of tin. In high copper alloys, corrosion is slower and limited
because e-phase is less susceptible to corrosion than g2-phase, which is
responsible for corrosion in low copper alloys.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 5

 • When amalgam comes in contact with dissimilar metal (gold restoration),
amalgam undergoes galvanic corrosion due to large difference in
electromotive force of two materials.
6) Biocompatibility
• Though there has been a great debate related to mercury toxicity, if careful
handling of mercury is taken, amalgam has proved to be a biocompatible
material.
7)Thermal Conductivity
• Because of good thermal conductivity, amalgam can transmit temperature
changes readily to the pulp.
• Therefore, it should be placed in tooth after adequate pulp protection like
sealing dentinal tubules by applying varnish to walls or placing base on
pulpal floor.
• Coefficient of thermal expansion of amalgam is three times more than that
of dentin. This large difference is responsible for microleakage.
8)Microleakage
• Microleakage occurs when there is 2–20 micron wide gap between the
amalgam and tooth structure. Following factors are responsible for
microleakage in amalgam:
◆ Poor condensation techniques that cause marginal voids
◆ Lack of corrosion by-products, which are necessary for sealing of margins
◆ High coefficient of thermal expansion of amalgam
◆ Use of single composition spherical alloys which show more leakage than
lathe-cut or admixed alloys.
Microleakage can lead to:
◆ Pulpal inflammation
◆ Tooth discoloration
◆ Postoperative sensitivity.
Indications for Amalgam Contraindications for Amalgam
Class 1 preparation When aesthetics is main concern:
Class 2 preparation Small class I and class II preparations:
Class 3, 5, 6 preparation Grossly decayed teeth:
Postendodontic restoration
In teeth with questionable prognosis
as interim restoration:
Tooth having fractured cusp:

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 6

 Advantage of Amalgam Disadvantage
Ease of Manipulation Unaesthetic
Self-sealing Ability Extensive Cavity Preparation
High Compressive Strength Corrosion & Noninsulating
Biocompatible Marginal Degradation
Good Wear Resistance Galvanism
Economical Brittle Material
Favorable Long-term Clinical Results Oral lichen Planus

Class I Cavity preparation for silver amalgam

Initial Cavity Preparation
1. Outline form
• Outline form means extending the preparation margins to the place they
will occupy in the final preparation, avoid ending preparation margins in
high-stress areas like cusp tip and crest of the ridges, and placing the
margins on sounds tooth structure .

Steps:
1. Take number 245 bur for cavity preparation. Its dimensions help in guiding
ideal cavity preparation, i.e. depth of cavity preparation, 1.5 mm (half thelength
of bur, i.e. 3 mm), to preserve marginal ridge of width 1.6–2 mm (double the
width of bur, i.e.0.8 mm), rounded internal line angles, and convergent external
walls (due to pear shape with rounded corners of the bur.
2. Using number 245 bur oriented parallel to the long axis of tooth, make a punch
cut in carious lesion .
3. Maintain the initial depth of 1.5 mm from central fissure at least 0.2–0.5 mm in
dentin. While maintaining the same depth and bur orientation, move the bur to
include defective pits and fissures .
4. Extend the margin mesially and distally but do not involve marginal ridges.
These walls should have dovetail shape to provide retention to the restoration.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 7

5. While working towards mesial and distal surface, orient the bur toward
respective marginal ridge. This results in slight divergence of mesial and distal
walls, which helps to provide dentinal support for marginal ridges.
6. Isthmus width should not be more than one-fourth of intercuspal distance.
7. Deep pit and fissure defects less than 0.5 mm apart should be included in
outline form.
8. External outline form should have smooth curves, straight lines, and rounded
angles. All unsupported and demineralized enamel should be removed.
9. Enameloplasty is done whenever required to remove sharp and irregular
enamel margins by “rounding” or “saucering”, thereby converting these into self-
cleansable areas. Enameloplasty should not extend the outline form.
Primary Resistance Form
Primary resistance is achieved by having following features in the preparation:
1. Box-shaped preparation with flat floors: This helps the tooth to resist occlusal
masticatory forces without fracture. Though floor should be flat, but it should also
follow the contour of occlusal surface.
2. Minimum occlusal depth of 1.5 mm, to provide adequate thickness ofamalgam.
3. Cavosurface angle of 90° (.
4. Restricting the extension of external walls so as to have strong marginal ridge
areas with sufficient dentin support.
5. Maintaining minimal width of cavity which is not more than 1/4th ofintercuspal
distance.
6. Keeping the pulpal floor 0.2 mm in dentin
7. Inclusion of all the weakened tooth structure.
8. Rounding off all the internal line and point angles.
9. Circumventing of cusps should be done for preserving cuspal strength and
achieving a smooth, free flowing outline form.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 8

Class II Cavity preparation for Amalgam Restoration
Initial Cavity Preparation
1. Outline form
• Outline form for occlusal portion follows the same principles as given for pit
and fissure lesions except that external outline is extended proximally
towards defective proximal surface. For description, a mesio-occlusal
preparation on mandibular second premolar is considered.
i. Establishing the Occlusal Step
• Using high-speed bur, make a punch cut in the pit closest to the involved
proximal surface. Keep long axis of the bur parallel to the long axis of the
tooth and maintain the initial depth of 1.5–2.0 mm.
• Extend the outline to include the central fissure while maintaining
uniformity in depth of pulpal floor.
• Make isthmus width as narrow as possible, not more than one-fourth of the
intercuspal distance. Give slight occlusal convergence to facial, lingual, and
proximal walls to provide retention for amalgam. A dovetail is provided in
the distal pit area to prevent mesial displacement of the restoration.
Consider enameloplasty wherever required to conserve tooth structure.
ii. Extending Occlusal Step Proximally
• While maintaining established pulpal depth, extend the preparation toward
proximal surface of tooth, ending 0.8 mm short of cutting through mesial
marginal ridge Proximal cutting .e sufficiently deep into the dentin (0.5–0.6
mm) so that retentive locks are prepared into axiolingual and axiofacial line
angles.
iii. Preparation of Proximal Box
• Widen the preparation faciolingually to just clear the contact areas.
Proximal cut is diverged gingivally. It results in greater faciolingual
dimension at gingival surface than occlusal surface. It provides good
retention and conservation of marginal ridge). Keep a small slice of enamel
at the contact area to prevent accidental damage to adjacent tooth

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 9

 Simple Box Preparation
Indications of simple box preparation:
◆ Small proximal caries, not involving the occlusal surface
◆ Proximal surface caries with narrow proximal contact
◆ Proximal caries in attrited teeth.

Reasons for Failure of amalgam restorations

1. Improper case selection
2. Improper cavity preparation
3. Faulty amalgam manipulation
4. Defective matrix adaptation
5. Post-restorative failures.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 10

A pin-retained restoration
• any restoration which requires the placement of pins in dentin in order to
provide sufficient retention and resistance form to the restoration.
Advantages
1. Conservation of tooth material: Pin amalgam resto-ration is more conservative
than tooth preparation for cast restoration.
2. Resistance and retention form: Use of pin increases resistance and retention of
the restoration.
3. Number of appointments: One appointment is required for pin-retained
restoration whereas for cast restoration, at least two appointments are required.
Indications
1. Extensive tooth loss: In teeth with extensive tooth loss where conventional
restoration may fracture, pins are indicated.
2. As a foundation for indirect restorations: Pin-retained restoration may be used
as foundation for indirect restorations like crowns or onlays.
3. Time period: Pin-retained restorations are restorations of choice for patients
who cannot come for multiple times (debilitated and aged patients).
4. Economics: It is economical as compared to expensive indirect cast gold
restorations.
5. Questionable prognosis: In teeth with questionable prognosis (pulpal or
periodontal), pin-retained resto-rations are used as interim restorations till their
prognosis is confirmed.
6. As core buildup after endodontic treatment: When little remaining tooth
structure is present, tooth is strengthened by pin amalgam before placing full
coverage restoration.
Contraindications

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 11

◆ When patient has occlusal problems
◆ When aesthetics is concerned, complex amalgam restorations are
contraindicated.
◆ In posterior teeth where accessibility and isolation for pin placement are
difficult.

Operative Dentistry Notes By Dr Danesh Kumar – JSMU (03312415069) 12