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Title The use of dental amalgam in a posterior dental restoration exhibits slight superiority in the overall success of the restoration when compared with resin bonded composites
Clinical Question In a healthy adult patient in need of a posterior dental restoration in a stress bearing region, how does the use of dental amalgam versus bonded resin composite correlate with the overall success of that restoration?
Clinical Bottom Line Dental amalgam exhibits a slight advantage in overall success when compared to a bonded resin composite in the posterior teeth, but the advantage is only very slight. (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) 11763918 Hickel/2000Patients with restorations of permanent teethMeta analysis of longitudinal, controlled clinical studies and retrospective cross-sectional studies
Key resultsAnnual failure rates for resin bonded composites were 0-9%, while the rates for dental amalgam were 0-7%. The median failure rates were 1.1% for amalgam and 2.1% for resin-bonded composite. Both types were analyzed in posterior stress bearing cavities. “Main reasons for failure were secondary caries, marginal deficiencies, fracture, and wear.”
#2) 15058177Sachdeo/2004133 patients with amalgam, composite, or open sandwich restorationsRandomized Controlled Trial
Key resultsThere was no statistically significant difference in wear at 1 year (p>0.05) between amalgam and composite. At 2 years, the amalgam restorations had significantly less wear than composite (p=0.033). Occlusal and proximal contacts in both groups of restorations were clinically satisfactory at 2 years.
Evidence Search "Dental Amalgam"[Mesh] AND "Composite Resins"[Mesh] AND ((Meta-Analysis[ptyp] OR Randomized Controlled Trial[ptyp]) AND English[lang])
Comments on
The Evidence
Longer-term studies comparing amalgam and composite restorations beyond 2 years would provide additional valuable information when deciding between the two restorative materials.
Applicability Any patient in need of amalgam or resin bonded composite on permanent teeth.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords amalgam, resin-bonded composite
ID# 523
Date of submission: 01/20/2010spacer
E-mail kartaltepe@uthscsa.edu
Author Christen Kartaltepe
Co-author(s) William S. Longino
Co-author(s) e-mail
Faculty mentor/Co-author H. Ralph Rawls, PhD
Faculty mentor/Co-author e-mail RAWLS@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?)
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Comments and Evidence-Based Updates on the CAT
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by Salimah Shariff (San Antonio, TX) on 04/10/2012
I performed a PubMed search on this CAT in April of 2012, and found a more recent publication: PubMed: 17545266. This randomized controlled trial on 472 patients found the same results as published in this CAT, but adds further documentation. The patients were between 8 and 12 years old at the start of the study, but were followed for several years, so I think they can be considered adults, as applied to this CAT question.

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