title: The effect of amalgam bonding on the stiffness of teeth weakened by cavity preparation.
abstract: OBJECTIVE
  The objective of this study is to evaluate the effect of amalgam bonding on the stiffness of teeth weakened by cavity preparation.
  
  
  METHODS
  Strain gages were bonded to maxillary premolars. The rigidity was tested by applying a load to a sequence of sound, prepared and restored teeth as follows: sound tooth, MOD preparation, amalgam restoration, amalgam removed recovering the MOD preparation, bonded amalgam restoration, bonded amalgam removed recovering the MOD preparation, bonded composite restoration. The relative stiffness (RS) and relative deformation (RD) of each condition for each cusp to that of the sound tooth was determined.
  
  
  RESULTS
  The premolar cusps were deformed 1.80, 2.14, and 2.32 times more than the cusps of the sound tooth for the three succeeding MOD preparations. For these three preparations, the stiffness of the premolar cusps was 0.58, 0.48, and 0.46 relative to a stiffness of 1.00 for the sound tooth. The deformation was 1.77, 1.27, and 1.16 for the non-bonded amalgam, the bonded amalgam, and the bonded composite, respectively, corresponding to a mean RS of 0.59, 0.80, and 0.88. The calculated mean stiffness parameter C (standard deviation) was 2.6% (6.9) for the amalgam restoration, 62.5% (12.8) for the bonded amalgam restoration, and 77.8% (15.8) for the bonded composite restoration. The stiffness parameter C measured the extent to which the procedure returned the stiffness of the restored tooth to the original stiffness of the intact tooth (100%).
  
  
  CONCLUSIONS
  Cavity preparation reduced the stiffness and weakened the tooth. Restoring the prepared tooth with unbonded amalgam did not restore the lost tooth stiffness. Restoring the prepared tooth with bonded amalgam or with bonded composite recovered a significant portion of the lost tooth stiffness. It was concluded that bonding amalgam to tooth structure could partly restore the strength and rigidity lost by the cavity preparation. This might lead to a reduction in cuspal flexure and the incidence of tooth fracture due to fatigue.
authors.affiliation: Division of Operative Dentistry, School of Dentistry, University of Minnesota, 8-450 Moos Tower, 515 Delaware Street, SE, Minneapolis, MN, USA. zidano@umn.edu
authors.forename: Omar
authors.initials: O
authors.lastname: Zidan
authors.forename: Usama
authors.initials: U
authors.lastname: Abdel-Keriem
mesh_terms: D000704:Analysis of Variance; D001641:Bicuspid; D003723:Dental Amalgam; D001840:Dental Bonding; D003737:Dental Cavity Preparation / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000379:methods*; D003799:Dental Stress Analysis; D006801:Humans; D018709:Statistics, Nonparametric; D019228:Tooth Crown / Q000503:physiopathology; D014082:Tooth Fractures / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D003723:Dental Amalgam