Amalgam
Amalgam
Amalgam
Historical Composition
G.V. Black believed that amalgam should consist of:
67% silver, 27% tin, 5% copper, and 1% zinc
Low-Copper (Traditional, Conventional) Amalgam
Composition:
Silver 60%
Tin 29%
Copper <6%
Zinc <2%
1
gamma-2 phase was reduced or eliminated. This resulted in the
dramatic improvement in physical properties.
2
high-copper amalgam exhibited a reduction in creep and an
increase in strength.6 A clinical study found that 5% and 10%
indium-containing alloys exhibited less margin breakdown but a
darker appearance and a rougher surface than Dispersalloy.7 A
five-year clinical study found that there was no significant
difference in surface luster or texture between indium-containing
alloys (5% and 10%) and Dispersalloy. Marginal breakdown was
significantly less for the indium-containing alloys, but the
difference was not felt to be clinically significant.8 Indium
added to an alloy in concentrations of 8% (or more) by mass also
was found to significantly reduce the amount of mercury vapor
emitted from the restoration, partially because indium decreases
the surface tension of liquid metals and therefore reduces the
amount of mercury necessary for trituration.9 Youdelis also
found that less mercury is required for mixing amalgam when it
contains indium in concentrations up to 10%.10,11 A second reason
for lower mercury emission is that amalgam prepared with indium
rapidly forms indium oxide and tin oxide films which reduce
mercury release.12 The indium must be in an admixed form,
however, to have these beneficial effects. If the indium is
added to the molten metal and atomized to produce spherical
particles, these effects are not seen. An example of this latter
type of indium-containing amalgam was Shofu's Indiloy which
contained 4% indium. Biological tests of indium-containing
amalgam show that it is no more cytotoxic or hemolytic than
standard ADA Certified amalgam.13,14 One currently marketed
indium-containing amalgam is Indisperse (Indisperse Distributing
Company), which contains 5% admixed indium.
Palladium: (in a 0.5% concentration in Ivoclar's Valiant
and Valiant PhD to reduce tarnish and corrosion); palladium-
containing alloys in vitro have been found to exhibit reduced
corrosion rates and in vivo have a slightly greater luster than
non-palladium alloys; they do not, however, have significantly
lower rates of marginal deterioration.15 In vivo, palladium has
been found in the gamma-1 and eta phases in high-copper amalgams.
3
As a general rule the SCSs are harder, stronger in
compression, and have lower creep and corrosion currents, while
the admixed lathe-cut with single-composition sphericals have
higher creep and corrosion currents. SCS alloys leak more than
admixed and lathe-cut ones.16 This may be due to the less
intimate adaptation the SCS amalgams exhibit to the walls of the
preparation.17 With SCS amalagams, mixes of proper plasticity
(i.e., wetter mixes) and good condensation techniques can reduce
the size of the gap between the amalgam and tooth structure.18
Generally the SCS alloys require a lower mercury-to-alloy
ratio than other types of high-copper amalgams. Some are as low
as 41%.
4
-contains Ag 49.5%, Sn 30%, Cu 20%, Pd 0.5%
-mercury content is 42.7% Hg
-palladium is added to increase corrosion resistance
of the silver phase
The second portion of the reaction involves the gamma 2 and the
silver-copper eutectic.
5
of metals which occurs when a large volume
fraction of ultra fine particles (usually <1
micron) is dispersed throughout the metal; it
was believed that the silver-copper particles
would act to impede dislocation movement and
strengthen the amalgam; the properties did
improve but the improvements were a result of
the higher concentrations of copper tying up tin
and reducing gamma 2 formation
-is 2/3 conventional lathe-cut alloy with 3% Cu,
and 1/3 eutectic consisting of 71.9 weight% Ag,
and 28.1 weight% Cu
-contains 69.3% Ag, 17.9% Sn, 11.8% Cu, 1% Zn; 50%
Hg is triturated with this alloy
Mercury Content
Residual mercury refers to the amount of mercury present in the
fully reacted alloy. It does not refer to free elemental
mercury, because none exists; it is all consumed within two hours
of trituration.19 Residual mercury levels are highest on the
surface and at the margins of a restoration. Certain
manipulative factors such as poor condensation technique and
delaying between trituration and condensation can increase
residual mercury levels.20 Using alloys which require high
mercury-to-alloy ratios can also result in high residual mercury
levels.
6
tarnish and corrosion resistance and increased creep because the
mercury converts gamma to gamma 1 and gamma 2.
7
General Characteristics of Amalgam
--ease of manipulation
--acceptable marginal adaptation
--technique insensitivity
--self sealing
--biocompatible
--good wear resistance
--low cost
Strength
--strength develops slowly, taking 24 hours or longer to
reach a maximum; by 1 hour, most alloys have achieved from 40% to
60% of their 24-hour compressive strength (e.g., Tytin 45% and
Dispersalloy 51%); by 24 hours, most alloys have reached 90% or
more of their final strength
--amalgam is considered a brittle material with much higher
compressive strength than tensile or shear strength; compressive
strength is 7 times that of tensile strength
--is weak in thin sections; unsupported edges fracture
easily; a 90° butt joint yields maximum strength while a 70°
angle of amalgam at the margins yields only 50% strength
--if loaded rapidly, amalgam will fracture quickly; if
loaded slowly, it will deform somewhat prior to fracture
--spherical alloys not only harden faster but are stronger
in compression than lathe-cut alloys; they are harder because
they require less mercury during trituration so less of the weak
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matrix portion forms
--must have a minimum 1-hour compressive strength of 11,600
psi (80 MPa) as required by hour as specified by ADA
Specification No. 1
Corrosion
9
--while corrosion is capable of reducing the strength of a
restoration by 50% in five years, a beneficial aspect of
corrosion is that the by-products that form act to seal the
cavity margin
--low-copper amalgams form corrosion products of tin oxides
and tin chlorides at both the tooth/amalgam interface (to seal
the margins and prevent leakage)26 and in the interior of the
amalgam; the most corrosion-prone phase in these alloys is gamma
2 (Sn8Hg)
--high-copper amalgams form corrosion products similar to
those formed by the low-copper alloys (tin oxides and tin
chlorides); in addition they form copper chloride;27 they corrode
slower than low-copper amalgams; it takes from 6 months to 2
years28 for high-copper alloys to self-seal their margins because
they contain little or none of the most corrosion-prone
phase, gamma 2; the most corrosion-prone phase in high-copper
amalgams is the eta phase (Cu6Sn5);29
--evidence indicates that zinc may reduce marginal fracture
by preferentially corroding instead of tin in the eta phase; this
reduces the rate of marginal corrosion and deterioration
Thermal Conductivity
--amalgam transmits temperature changes readily to the pulp
because of its relatively high thermal conductivity
Microleakage of Amalgam
--factors that promote microleakage
---the 2- to 20-micron-wide gap that always exists
between the amalgam and tooth structure
---poor condensation techniques that result in
marginal voids
---a lack of corrosion by-products necessary to seal
the margins
---a coefficient of thermal expansion for amalgam
which is 22 times greater than the coefficient
for tooth structure
---use of single-composition-spherical alloys which
leak more than lathe-cut or admixed alloys;21,30
this may be because they do not adapt as well to
the margins of the preparation31
10
--no evidence exists that creep is a predictor of clinical
performance for high-copper amalgams; the reason is that creep
rates for these alloys are much less than 1% and, at these low
levels, creep does not result in clinically significant marginal
deterioration
--strength is probably the least important characteristic
because all commercially available amalgams easily exceed the
minimum requirement found in ADA Specification No. 132
--a selection should also be based on the handling
characteristics that the clinician wants; for instance:
*spherical alloys
+advantages: are easier to condense into areas of
difficult access (such as around pins) because they
provide less resistance to condensation pressures;
they harden rapidly; are smoother for carving,
burnishing, and polishing
-disadvantages: are difficult to achieve tight
interproximal contacts with because of their
Aplashy@ nature
*lathe-cut alloys
+advantages: are easier to achieve tight
interproximal contacts with because they resist the
forces of condensation well
-disadvantages: are more difficult to condense into
areas of difficult access (such as around pins)
because they provide greater resistance to
condensation pressures; they harden more slowly
than spherical alloys which means a greater chance of
marginal ridge fracture during matrix band
removal; are not as smooth for carving, burnishing, and
polishing
*admixed alloys
have the advantages of spherical alloys but not
their disadvantages; have the "body" of lathe-cut
alloys when condensing; are easily condensed with
good adaptation
Trituration
--the purpose is to remove oxide layers from the alloy
particles, to coat each alloy particle with mercury, and to
provide a homogeneous mass for condensation
--manufacturers provide a range of recommended trituration
times for each alloy; the time needs to be adjusted depending on
the triturator being used
--signs of a good mix: a shiny, homogeneous mass that
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adheres together
--undertrituration (i.e., triturating for shorter than the
recommended time) results in a crumbly mix that is very weak; it
decreases tensile and compressive strength values (for spherical
alloys) and increases creep; never undertriturate
--overtrituration (i.e., triturating for longer than the
recommended time) results in a mix that is warm and has a dull
surface; often the mix sticks to the capsule; it shortens setting
time (because the amalgam mass becomes heated), increases
contraction, and increases creep; also increases tensile and
compressive strength values (for lathe-cut alloys), decreases
tensile and compressive strengths (for spherical alloys);
overtrituration by 10% is acceptable
Condensation
Objectives:
--to adapt amalgam to the walls and floors of the
preparation, around pins, etc.
--to eliminate voids in the amalgam mass
--to remove excess mercury which leads to a stronger
12
restoration
Rules of Condensation:
--have a constant supply of amalgam
--constantly condense
--condense laterally as well as apically
--condense with adequate force
Carving
--it is best to overpack the cavity preparation and carve to
the margins in order to reduce the mercury-rich surface layer
--occlusal anatomy should be kept somewhat shallow to
preserve bulk of the alloy at the margins; you do not want an
acute angle of amalgam at the margins
--some operators advocate a two-step burnishing technique;
the initial burnishing is done following condensation and helps
to improve marginal integrity; the second burnishing is done
after carving to reduce surface roughness
--burnishing has also been shown to reduce leakage;35,36 pre-
and post-carve burnishing together are more beneficial in
reducing leakage than is pre-carve or post-carve burnishing
alone37
--some clinicians avoid burnishing because they believe it
draws mercury to the surface of the restoration, however this has
not been shown to be the case
--increasing the percentage of spherical particles in the
13
alloy improves carvability and polishability
Polishing Procedure:
--begin with a pre-carve burnishing; this is really an
extension of condensation which removes mercury from the surface
--follow with initial carving and removal of the matrix
--perform final carving
--do post-carve burnishing
--you must burnish the amalgam before it is set; if it looks
shiny during burnishing, the burnishing is probably not doing
much good because the amalgam has already set
--use a small instrument (e.g., ball burnisher, Dycal
applicator) and apply light pressure down the margins and in the
grooves
--Leinfelder has proposed that this burnishing is a useful
step if you do not intend on polishing the restoration
--following post-carve burnishing, use a prophy cup with
prophy paste to lightly polish the restoration; this gives it a
smooth matte finish which helps to reduce the time necessary at a
future appointment for polishing
Be aware of the need to use light pressure with rubber points and
cups because they can otherwise generate heat. If the
temperature of the amalgam exceeds 140°F, the pulp may be injured
and mercury will leach to the surface of the restoration leaving
the marginal areas mercury-rich. This can result in more
marginal ditching and fracture. A water coolant is always
advised when polishing and finishing amalgam restorations.40
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2. Phillips RW, Swartz ML, Boozayangool R. Effects of moisture
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