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Title Improved Longevity of Large Amalgam Restorations in the Posterior teeth of Children Compared with Composite Restorations
Clinical Question In a patient requiring a restoration on a posterior tooth, should dental composite resin or dental amalgam be chosen in regards to longevity of the restoration?
Clinical Bottom Line In regards to longevity of the restoration, use of amalgam appears to be preferable to use of composites in multi-surface restorations of posterior teeth in children. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17545266Bernardo/2007472 children needing posterior tooth restorationsRandomized clinical trial
Key resultsThe authors concluded that “amalgam restorations performed better than did composite restorations. The difference in performance was accentuated in large restorations and in those with more than three surfaces involved.” (page 775)
#2) 17545265Soncini/2007Children aged 6 to 10 years who had two or more posterior occlusal carious lesionsRandomized clinical trial
Key resultsThe authors concluded that “although the overall difference in longevity was not statistically significant, composite restorations required seven times as many repairs as did amalgam restorations.” (page 763)
Evidence Search Search Most Recent Queries Time Result Limits: Clinical Trial "Composite Dental Resin "[Substance Name] "Dental Amalgam"[Mesh]
Comments on
The Evidence
Information comparing dental amalgam and resin composite longevity in posterior restorations is limited. These two trials compare the longevity of the materials in children with posterior decay. A clinical trial needs to be conducted using adults as a patient group to determine if the clinical outcome would be duplicated in an aged adult dentition.
Applicability The results of these trials can be applied to children in need a posterior dental restoration.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords "Dental Amalgam"[Mesh],"Composite Dental Resin "[Substance Name], longevity, clinical trial, amalgam, dental resin composite
ID# 504
Date of submission: 01/07/2010spacer
E-mail simont@uthscsa.edu
Author Emily Whittington
Co-author(s) Tiffany Simon
Co-author(s) e-mail
Faculty mentor/Co-author Ridley Ross, DDS
Faculty mentor/Co-author e-mail rossr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Kristy Hong (San Antonio, TX) on 04/13/2012
I conducted a PubMed search on this topic April 2012 and found a more recent publication: PubMed ID 20660797. This RCT on 1949 large class II restorations finds same results as published in this CAT but adds further documentation.
by Anna Windham (Center, TX) on 06/29/2011
In my clinical experience amalgam is a better restorative material than composite in large posterior restorations. I have seen less recurrent decay when using amalgam in these situations. I have also found that even under the best clinical conditions composite does not perform as well as amalgam in high caries risk patients.

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