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Comparative Dental Materials

service-other-services Resistance to Fracture Amalgam may fracture under stress; tooth around filling may fracture before amalgam does. Good resistance to fracture.Brittle; low resistance to fracture but not recommended for stress-bearing restorations.Tougher than glass ionomer, recommended for stress-bearing restorations in adults.

Types of Direct Restorative Materials
Comparative FactorsSilver AmalgamComposite Resin(Direct & Indirect Restorations)Glass Ionomer CementResin Reinforced- Glass Ionomer Cement
Number of Visits RequestedSingle visit (polishing can be done at next visit)Single visit for fillings (2+ visits when used for indirect inlays & crowns, etc.)Single visit       Single visit
General DescriptionSelf-hardening alloy of silver-tin-mercuryLight Cured mixture of powdered glass and plastic resinSelf-hardening mixture of organic acid and powdered glassSelf-hardening or Light Cured mixture of composite polymer and organic acid
Principle UsesFillings; sometimes replacing portions of broken teethFillings,inlays, veneers; sometimes replacing portions of broken teethCementing crowns, temporary fillings, or lining the base of a cavityCementing crowns, temporary fillings, or lining the base of a cavity
Resistance to Further DecayHigh; corrosion of material causes a self-sealing characteristic but recurrent decay around amalgam is difficult to detect in its early stages.Moderate; recurrent decay is easily detected in early stages.Low-Moderate; some resistance to decay is due to fluoride release.Low-Moderate; some resistance to decay is due to fluoride release.
Estimated DurabilityDurableStrong, durable.Low, no-stress bearing crown cementLow, non-stress bearing crown cement
Relative Amount of Tooth PreservedFair, requires removal of healthy tooth to be mechanically retained; requires minimal thickness of 2mm for strength.Excellent; bonds adhesively to healthy enamel and dentin.Excellent; bonds adhesively to healthy enamel and dentin.Excellent; bonds adhesively to healthy enamel and dentin.
Resistance to Surface WearLow, similar to dental enamel; brittle metal.May wear slightly faster than dental enamel.Poor in stress-bearing applications. Fair in non-stress bearing applications.Poor in stress-bearing applications. Good in non-stress bearing applications.
Resistance to LeakageGood; self-sealing due to surface corrosion; margins may chip over time.Good if properly bonded to enamel; may show leakage over time when bonded to dentin; Does not corrode.Moderate; tends to crack over timeGood; adhesively bonds to resin, enamel, dentin/post-insertion expansion may help to seal margins.
Resistance to Occlusal StressHigh; but lack of adhesion may weaken the remaining tooth.Good to excellent depending upon product used.Poor; not recommended for stress-bearing restorations.Moderate; not recommended to restore biting surfaces of adults; suitable for short-term primary teeth restorations.
ToxicityGenerally safe; occasional allergic reactions to metal components. Amalgams contain mercury. Mercury by itself is toxic, although it is chemically inert when bound in amalgam.Safe; no known toxicity documented. No known incompatibilities Safe; no known toxicity documented.No known incompatibilities Safe; no known toxicity documented.
Allergic or Adverse ReactionsRare; recommend that dentist evaluate patient to rule out metal allergies.No documentation of allergic reactions has been found.No documentation for allergic reactions was found. Progressive roughening of the surface may predispose to plaque accumulation and periodontal disease.No documentation for allergic reactions was found. Progressive roughening of the surface may predispose to plaque accumulation and periodontal disease if the material contacts the gingival tissue.
Post-Operative SensitivityMinimal; High thermal conductivity may promote temporary sensitivity to hot and cold; Contact to other metals may cause occasional galvanic electrical sensations.Moderate; Material is sensitive to dentists’ proper technique. Material shrinks slightly when hardened, and a poor marginal seal may lead to bacterial leakage, recurrent decay and tooth hyper-sensitivity.Low; material seals well and does not irritate pulpLow; material seals well and does not irritate pulp.
Esthetics (Appearance)Very Poor. Initially silver-gray, gets darker & black as it corrodes. May stain tissues black over time.Excellent; often indistinguishable from natural tooth.Good; tooth colored, varies in translucency.Very good; more translucency than glass ionomer.
Frequency of Repair or ReplacementLow; replacement is usually due to fracture of the filling or the surrounding tooth.Low-Moderate; durable material hardens rapidly; More rapid wear than amalgam. Replacement is usually due to marginal leakage.Moderate; Slowly dissolves in mouth; easily dislodged.Moderate; more resistant to dissolving than glass ionomer, but less than composite resin.
Relative Cost to PatientLow, relatively inexpensive; actual cost of fillings depends on their size.Moderate; higher than amalgam; actual cost of fillings depends on their size.Moderate; similar to composite resin (not used for veneers and crowns).Moderate; similar to composite resin (not used for veneers and crowns).
 Silver AmalgamComposite Resin(Direct & Indirect Restorations)Glass Ionomer CementResin Reinforced- Glass Ionomer Cement

 

Types of Indirect Restorative Dental Material
Comparative FactorsGold Alloys(Noble)Nickel or Cobalt-Chrome Alloys(Base Metal)Porcelain(Ceramic Only)Porcelain(Fused to Metal)Porcelain(Fused to Ceramic)
Number of Visits Requested2 Visits (minimum)2 Visits (minimum)2 Visits (minimum); matching esthetics may require more visits.2 Visits (minimum); matching esthetics may require more visits.2 Visits (minimum); matching esthetics may require more visits.
General DescriptionMixture of gold, copper, palladium and other metals used for inlays, onlays, crowns & bridgesMixture of nickel & chromiumGlass-like material baked into crown forms using models of the prepared teethGlass-like material that is baked onto metal shells; used for crowns & bridgesGlass-like material that is baked onto ceramic shells – can be alumina, zirconium or a combination of both, used for crowns & bridges
Principle UsesCast metal crowns & bridgesCast metal crowns & bridges; most Removable Partial Denture (RPD) frameworksInlays, veneers, crowns and bridgesCrowns & bridgesCrowns, bridges & implant abutments
Resistance to Further DecayGood if the restoration fits well.Good if the restoration fits well.Good if the restoration fits well.Good if the restoration fits well.Good if the restoration fits well.
Estimated DurabilityExcellent.  Does not fracture under stress; does not corrode in the mouth.  Actually gets smoother (burnishes) with time.Excellent.  Does not fracture under stress; does not corrode in the mouth. Moderate.  Brittle material that may fracture under high biting forces.  Not recommended for posterior (molar) teeth.Very Good. Less susceptible to fracture due to the metal substructure.Good. Porcelain-Ceramic bond is greater than Porcelain Fused to Metal.  Brittle substructure is more likely to fail at the onset of a problem than metal, therefore easier to detect problems and recurrent decay.
Relative Amount of Tooth PreservedGood. A strong material that requires removal of a thin outside layer of the tooth.Good. A strong material that requires removal of a thin outside layer of the tooth.Good-Moderate. Little removal of natural tooth is necessary for Veneers; more for crowns since porcelain strength is related to its bulk (thickness).Moderate-High. More tooth must be removed to permit the metal to accompany the porcelain.Moderate. Less tooth must be removed than metal-porcelain crowns to achieve the same esthetic result.
Resistance to Surface WearSimilar hardness to natural enamel; does not abrade opposing teeth.Harder than natural enamel but minimally abrasive to opposing natural teeth.Resistant to surface wear; but abrasive to opposing teeth.Resistant to surface wear; permits either metal or porcelain on the biting surface of crowns and bridges.Resistant to surface wear; but abrasive to opposing teeth. Same as all porcelain.
Resistance to FractureDoes not fracture in bulk.Does not fracture in bulk.Poor resistance to fracture.Porcelain surface may fracture.Moderate resistance to fracture. Will fracture when undermined by decay, does not mask problems.
Resistance to LeakageVery good-Excellent. Can be formed with great precision and can be tightly adapted to the tooth.Good-Very Good – Stiffer than gold; less adaptable, but can be formed with great precision.Very Good. Can be fabricated for very accurate fit of the Crown margins.Good – Very Good depending on the design of the Crown margins.Good – Very Good depending on the design of the Crown margins.
Resistance to Occlusal StressExcellentExcellentModerate; brittle material susceptible to catastrophic fracture under biting forces.Very good. Metal substructure gives high resistance to fracture.Good. Ceramic substructure gives moderate resistance to fracture. Will fracture when undermined by decay, does not mask problems.
ToxicityNone; No known adverse effects.None; Occasional/ rare allergy to metal alloys used.None; No known adverse effects.None; Occasional/ rare allergy to metal alloys used.None; No known adverse effects.
Allergic or Adverse ReactionsExtremely rare; occasional allergic reactions seen in susceptible individuals.Rare; Nickel allergies are common among women, although rarely manifested in dental restorations.None.Rare; Occasional allergy to metal substructures.None.
Post-Operative SensitivityConducts heat and cold; may irritate sensitive teeth.Conducts heat and cold; may irritate sensitive teeth.Not due to material, only due to over-preparation of tooth.Not due to material, only due to over-preparation of tooth.Not due to material, only due to over-preparation of tooth.
Esthetics (Appearance)Poor- gold colored metal.Poor- dark silver metal.ExcellentGood to ExcellentExcellent
Frequency of Repair or ReplacementInfrequent; replacement is usually due to recurrent decay around margins.Infrequent; replacement is usually due to recurrent decay around margins.Varies; depends on biting forces; fractures of molar teeth are more likely than anterior teeth; porcelain fracture may often be repaired with composite resin.Infrequent; porcelain fracture can sometimes be repaired with composite resin.Infrequent; depends on biting forces; fractures of molar teeth are more likely than anterior teeth. In most cases, fracture indicates a problem which ceramic materials will not hide (unlike metal).
Relative Cost to PatientHigh; requires expensive materials and laboratory services.High; less expensive than cast gold materials, but laboratory services as well.High; requires expensive materials and laboratory services.High; requires expensive materials and laboratory services.Highest; requires expensive materials and CAD/CAM laboratory services [Computer Aided Design and Manufac-turing]
 Gold Alloys(Noble)Nickel or Cobalt-Chrome Alloys(Base Metal)Porcelain(Ceramic Only)Porcelain(Fused to Metal)Porcelain(Fused to Ceramic)

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