Comparison of Direct Restorative Dental Materials

The American Dental Association (ADA) recommends that we share this form with all of our patients before undergoing filling restorative procedures so that the patient is aware of his/her filling material options.

FACTORS
AMALGAM
COMPOSITES Direct and Indirect
GLASS IONOMERS
RESIN-IONOMERS
General Description
A mixture of mercury and silver alloy powder that forms a hard solid metal filling. Self-hardening at mouth temperature.
A mixture of submicron glass filler and acrylic that forms a solid tooth-colored restoration. Self- or light-hardening at mouth temperature.
Self-hardening mixture of fluoride containing glass powder and organic acid that forms a solid tooth colored restoration able to release fluoride.
Self or light- hardening mixture of sub-micron glass filler with fluoride containing glass powder and acrylic resin that forms a solid tooth colored restoration able to release fluoride.
Principal Uses
Dental fillings and heavily loaded back tooth restorations.
Esthetic dental fillings and veneers.
Small non-load bearing fillings, cavity liners and cements for crowns and bridges.
Small non-load bearing fillings, cavity liners and cements for crowns and bridges.
Leakage and Recurrent Decay
Leakage is moderate, but recurrent decay is no more prevalent than other materials.
Leakage low when properly bonded to underlying tooth; recurrent decay depends on maintenance of the tooth-material bond.
Leakage is generally low; recurrent decay is comparable to other direct materials, fluoride release may be beneficial for patients at high risk for decay.
Leakage is low when properly bonded to the underlying tooth; recurrent decay is comparable to other direct materials, fluoride release may be beneficial for patients at high risk for decay.
Clinical Considerations
Tolerant to a wide range of clinical placement conditions, moderately tolerant to the presence of moisture during placement.
Must be placed in a well-controlled field of operation; very little tolerance to presence of moisture during placement.
Resistance to Wear
Highly resistant to wear.
Moderately resistant, but less so than amalgam.
High wear when placed on chewing surfaces.
Resistance to Fracture
Brittle, subject to chipping on filling edges, but good bulk strength in larger high- load restorations.
Moderate resistance to fracture in high-load restorations.
Low resistance to fracture.
Low to moderate resistance to fracture.
Biocompatibility
Well-tolerated with rare occurrences of allergenic response.
Post-Placement Sensitivity
Early sensitivity to hot and cold possible.
Occurrence of sensitivity highly dependent on ability to adequately bond the restoration to the underlying tooth.
Low.
Occurrence of sensitivity highly dependent on ability to adequately bond the restoration to the underlying tooth.
Esthetics
Silver or gray metallic color does not mimic tooth color.
Mimics natural tooth color and translucency, but can be subject to staining and discoloration over time.
Mimics natural tooth color, but lacks natural translucency of enamel.
Mimics natural tooth color, but lacks natural translucency of enamel.
Relative Cost to Patient
Generally lower; actual cost of fillings depends on their size.
Moderate; actual cost of fillings depends on their size and technique.
Moderate; actual cost of fillings depends on their size and technique.
Moderate; actual cost of fillings depends on their size and technique.
Average Number of Visits To Complete
One.
One for direct fillings; 2+ for indirect inlays, veneers and crowns.
One.
One.

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