The future of dental amalgam: a review of the literature. Part 7: Possible alternative materials to amalgam for the restoration of posterior teeth.

This is the last in a series of articles on the future of dental amalgam. It considers possible alternative materials to amalgam for the restoration of posterior teeth. The materials discussed are gold inlays, gold foil, gallium alloys, and tooth coloured non-metal alternatives including glass-ionomer cements, composite resins, glass-ionomer-resin hybrids, compomers and ceramics. The clinical indications for these restorations are first described along with their potential clinical problems and their mean survival rates in comparison with dental amalgam. Secondly, the safety of composite resins is considered and potential toxic and hypersensitive effects of these materials are discussed. Finally, it is concluded that the present evidence does not appear to demonstrate that dental amalgam is hazardous to the health of the general population. It does, however, recommend that in continuing to use amalgam dentists must use strict mercury hygiene procedures to avoid risk to their staff and contamination of the environment. It seems that mercury contamination of the environment is likely to be the main reason for any future government action against the continued clinical use of dental amalgam.