I read with interest "The Integrity of Bonded Amalgam Restorations: A Clinical Evaluation After Five Years" by Dr. Michal Staninec and colleagues in April JADA, even though I’m one of the "renegades" who feel it is an inferior restorative and therefore place very few of them these days.
My limited experience over the last several years convinces me that bonded restorations are superior, and that opinion seems to be justified by the photographs of the bonded and unbonded cases at the five-year evaluations. Clearly, the teeth supporting the bonded restorations have not taken on nearly as much of the unsightly blue-gray discoloration that is such an important disadvantage of the material. I realize this could be attributed to factors such as the inherent structure of the teeth, or even the photographic light differences, though I’ve observed the same phenomenon in practice.
More significantly, there is an obvious difference in marginal integrity that I’m surprised wasn’t addressed in the article. It’s unfortunate there weren’t more cases to view so the reader could better judge the findings, but, frankly, the unbonded cases appear to exhibit marginal leakage already at the five-year examination.
The practical value of the study seems questionable. I would hope restorations are generally successful at five years or we would not be able to keep up with their replacement among our patients.
