Failed Amalgam Fillings and their Relationship to Periodontal Health

Abstract

Objective: Faulty/failed restorations have been shown 
to be causes of gingival inflammation and periodontal 
disease. The objective of the study was to evaluate the 
defects associated with failed amalgam restorations as 
well as assess the effect of failed amalgam restorations 
on periodontal health
Methods: This was a prospective interventional study of 
patients who presented at the conservative clinic of 
University of Benin Teaching Hospital (UBTH) with 
failed amalgam fillings. These teeth were evaluated 
clinically and radiographically to determine the type of 
defect in the tooth with failed amalgam filling. The 
defects were then classified as follows: tooth fracture, 
restoration fracture, bulk amalgam fracture, recurrent 
caries, marginal defect, cervical overhang and fractured 
cusp. The periodontal health of the teeth was examined 
before and after intervention using the Basic 
Periodontal examination (BPE). The data obtained was 
analyzed using IBM SPSS version 21.0.
Results: Forty-one participants consisting of 19 (46.3%) 
males and 22 (53.7%) females with 49 teeth that had 
failed amalgam restorations were recruited for the 
study. Majority of the teeth (85.7%) were molars with 
the first molar accounting for 51.0%. More than half 
(51.0%) of the restorations were approximal 
restorations. The teeth with failed amalgam fillings had 
various defects which were multiple in 49% of the teeth. 
Majority of teeth with secondary caries and multiple 
causes of failure were categorized as BPE code 2 and 
this were statistically significant (P<0.05). There was 
improvement in periodontal health after intervention 
with all teeth recording BPE 0.
Conclusion: The most prevalent defect observed in 
teeth with failed amalgam fillings was fracture of a part 
of the amalgam filling. Failed amalgam fillings have a 
detrimental effect on periodontal health with secondary 
caries and multiple defects significantly associated with 
worse periodontal health. Replacement of failed fillings 
improved periodontal health significantly.