Direct Restorative Materials - What Are the Alternatives?
Amalgam is not widely used in Japan since the usage is exempted from the health insurance in decades, but in UK, USA and several other countries it is still quite often used.
The Minamata convention has become active in 2017 and agreeing countries which are still using amalgam must take measures to phase down the use of dental amalgam.
In the last decade several new alternative materials were developed and introduced, e.g. self- and light-curing bulkfill composites, GIC and Glass-Hybrid etc. There are quite big differences in matrix, initiator, particle size and filler amount of these bulkfill materials and hence also in mechanical properties (e.g. shrinkage stress, flexural strength, hardness, etc.). Up to now only for few materials (e.g. Equia or Equia forte) clinical data with an observation period of 5 years or more are available. It is recommended to use products were sufficient clinical longevity data are available.
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