Objectives: Amalgam restorations are replaced by adhesively placed composite resin restorations at an increasing rate. After the removal of amalgam dentine often shows marked dark discoloration that is attributed to the penetration of corrosion products from overlying amalgams. It is questioned whether penetration of metals into dentine affects the dentine as a substrate for adhesive procedures. This study has been performed to clarify the origin of dark discoloration of dentine by metals from amalgam with special regards to corrosion products.
Methods: A review of the literature has been performed using Medline database. As keywords dentine and amalgam, subsequently combined with penetration, interface, crevice, interaction, corrosion, were used. This was followed up by extensive hand search using reference lists of relevant articles.
Results: Data in the literature have been gathered from extracted amalgam filled teeth and from artificially aged amalgam filled teeth. Corrosion studies have been performed in vivo aged teeth as well as in vitro. Sn is the main element, followed by Zn and Cu, that is consistently found in dentine underneath amalgam, as well as in amalgam corrosion products and in marginal seal deposits. Penetration of elements from amalgam has only been observed in discolored and in demineralised dentine.
Conclusions: Darkly discolored dentine as found underneath amalgam restorations contains amalgam corrosion products and is demineralised. Therefore it must be considered a different substrate for clinical procedures than sound dentine.