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Replacing Silver Amalgam with Tooth Colored Composite Resin: Case 1

This is literally stuff we do every day. Most fillings that are replaced are still amalgam and I’m using composite resin tooth colored fillings exclusively for this purpose. This is for a few reasons. Most people want tooth-colored fillings these days. They hold up about equally with amalgam but they have the distinct advantage of being bonded to the tooth which creates a great seal (less micro-leakage) and also with the current dentin bonding systems result in nearly zero sensitivity experienced by my patients. If they do leak over time as bonds weaken it is most often visible to the naked eye so they can often be repaired very conservatively. Also, again because they are bonded I can prepare teeth much more conservatively meaningless tooth needs to be removed. And lastly studies show that when bonded fillings are placed as the initial restoration the tooth is just as strong as it was before it was filled. Certainly nearly so. This is clearly not the case with amalgam which often expands and cracks teeth over time. In my estimation probably fifty percent or greater of the large amalgams that are removed demonstrate varying degrees of cracks in the underlying tooth. There is also often hidden decay discovered under these same restorations that is mostly from undetected leakage. Composite resin has rapidly overtaken amalgam as the material of choice for simple fillings.