A short ppt on dental amalgam clinical aspects for An Undergraduate level presentation.

1. Good Afternoon….

2. DENTAL
AMALGAM-
CLINICAL
ASPECTS
Dr.Mettina
II MDS
Department of Conservative
dentistry & Endodontics

3. RAPID RECAP
 DentalAmalgam is a metallic restorative material composed of a
mixture of silver-Tin copper alloy & mercury.
 The unset mixture is pressed into a cavity to restore the tooth
form.

4. CONTENTS
 Introduction
 G.V. Black’s Classification
 Cavity Design
 Indications/ Contraindications
 Principles of Cavity design
 Placement technique
 Armamentarium
 Trituration
 Steps in placement
 Setting of Amalgam
 Burnishing & Carving
 Finishing & Polishing
 Advantages/Disadvantages
 Mercury Hygiene
 Conclusion

5. INTRODUCTION

7. `

8. Indications
 1. Moderate to large Class 1 & 2 restorations that involve heavy
occlusion.
 2.Temporary caries control restorations.
 3. Foundations- Core build up material.

9. Contraindications
 1. Patients who are allergic to alloys
 2. In aesthetic areas of the mouth.
 3.Wherever composite restorations can be used.

10. Principles of
Cavity design
 Initial tooth preparation stage
- Outline form & initial depth.
- Primary resistance form
- Primary retention form
- Convenience form
 Final tooth preparation stage
- Removal of remaining infected dentin or old restorative material.
- Secondary resistance & retention forms.
- Procedures for finishing external walls
- Final procedures

11. Anatomy of a
cavity??

12. Outline form
 Preparation extent- determined by existing amount of caries.
 Strength of cusps & marginal ridges should be preserved.
 Initial depth of the preparation is 0.2 mm internal to the DEJ or 1.5
mm from the central groove.

13. Primary
resistance form
 Resistance form of preparation helps the restoration & the tooth
to resist fracture caused by occlusal forces.
 Preserving cusps & marginal ridges.
 Pulpal & Gingival walls perpendicular to occlusal forces.
 Rounded internal preparation angles.
 Removing unsupported tooth structure.

14. Resistanceform
 Adequate amalgam thickness ( 1.5- 2.0 mm in areas of occlusal
contact),( 0.75 mm- axial areas) .
 Box preparation- adequate amalgam thickness.
 Rounded axio pulpal line angle.

15. Retention form
 Occlusally convergent facial & lingual walls.
 ‘ Dovetail outline of preparation.

16. Convenience
form
 Convenience form features make the procedure easier or the area
more accessible.
 Easy instrumentation.
 Establishing clearance.

17. Finaltooth
preparation
 Removal of residual caries or old restoration

18. Secondary
resistance &
retention forms

19. Finishing the
externalwall

20. Cleaning ,
inspecting ,
Desensitizing
 Remove visible debris
 Use desensitizers if needed.

21. Clinical
Techniques
 Initial clinical procedures
 Local anaesthesia
 Isolation of operating site.
 Cavity cutting
 Placement of Bases, liners,Varnishes
 DispensingAmalgam
 What is trituration?
 PlacingAmalgam
 Setting of amalgam
 Carving & Finishing
 Occlusal correction
 Postoperative instructions

22. Local
Anesthesia

23. Isolation

24. Cavity
Preparation

25. Armamentarium

26. Bases , Liners ,
Varnishes

27. Dispensing
Amalgam

28. What is
trituration?
 The objective of trituration is to provide proper amalgamation of
the mercury and alloy.
 There is always an oxide layer of the alloy surface that hinders
diffusion of mercury into the alloy.
 This film must be disrupted so that a clean surface of alloy can
make intimate contact with the mercury.
 The oxide layer is removed by abrasion when the alloy particles
and mercury are triturated.


29. Eames minimal
mercury
technique  A procedure for mixing dental amalgam in approximately a 1:1 ratio
of mercury and alloy to minimize free mercury in the unset mix.

30. Amalgam
placement
Condensing Pre-carve Burnishing

31. Carving &
Finishing
Carving Post carve burnishing

32. Occlusal
correction

33. Postoperative
instructions
 Do not eat for 1 hour or until the numbness subsides.
 Do not bite on hard foodstuff for 24 hours & do not chew on the
side of the filling.
 Sensitivity to heat & cold is common, educate the patient.

34. Advantages
 Ease of use
 High compressive strength
 Excellent wear resistance.
 Favourable Longevity.
 Lower cost.

35. Disadvantages
 Non- Esthetic.
 Less conservative
 Non- Insulating
 More difficult tooth preparation.
 Initial marginal leakage.

36. Mercury
management
 Mercury has the potential to be hazardous if not managed
properly.
 When amalgam sets, extremely linute levels of mercury are
released.
 Dentist is more at risk than the patient.

37. Conclusion
 Amalgam is a safe & effective direct restorative material.
 Amalgam restorations are a clinical success.
 Although there are many controversies surrounding this material,
its legacy remains……