Composite resin fillings

Abraham Stein, DMD, MS and Nechama Y. Brand, DDS replaces silver amalgam fillings with tooth-colored composite materials only if the existing silver amalgam restoration is defective, or at the request of a patient who is informed about the risks of replacement. The 2014 position paper of the American College of Prosthodontists does not support the replacement of silver amalgam fillings with composite resin for health reasons.

Direct and Indirect

Composite resins may be placed directly into a tooth in one appointment (direct), or the composite resin filling may be made outside the mouth from an impression of the tooth, and bonded into place at a second appointment (indirect).

Longevity of composite resins

A recent systematic review found no difference in the longevity of direct and indirect composite resin restorations (Conguista, 2017).  The longevity of composite resin restorations depends upon whether they are placed in front or in back teeth, and upon the type of tooth defect needing repair.  One case control study found the mean survival time of composite resin restorations to be 11.6 years, with a large range of 5 to 20 years (Borgia and others, 2017).