Composition and Properties of Dental Amalgam

Question 1

Amalgam comes in different packagesAll the amalgam we use in clinic is ___ ____

___r to use

All the material is inside a capsule

Different materials have different structures so make sure you know what you are using

Answer 1

Amalgam comes in different packagesAll the amalgam we use in clinic is pre-capsuled

Easier to use

All the material is inside a capsule

Different materials have different structures so make sure you know what you are using

Question 2

Composition of Dental Amalgam Capsule

___

___ ___ ___

There is a __ ___to separate both components

When you are ready to use it, there are ways to __ __ ___ and mix the two components so that a chemical reaction starts

Answer 2

Composition of Dental Amalgam Capsule

Mercury

Amalgam alloy powder

There is a thin film to separate both components

When you are ready to use it, there are ways to break the film and mix the two components so that a chemical reaction starts

Question 3

Overview of ManipulationTime:

• Onset of ___
  
  • The clock starts ticking
  • ____: how we mix amalgam
  • Done with a___r or ___
  • ___ the capsule and then __ __ __ the amalgamator
• Onset of ___
  
  • ___and ___
  • Place the___ in your ___
• Onset of ___
  
  • __
  • When the material starts to set, you carve the amalgam
• ___of Setting
  
  • Material is very ___ Can’t manipulate it
• 24 hours
  
  • ___
  • Don’t polish until after 24 hrs
• Steps:
  
  • ____
  • ____
    
    • Proportion of 2 components is set in capsule
  • ___
    
    • Chemical rxn
  • ____
    
    • Your manipulation will influence the properties
  • ___

Answer 3

Overview of ManipulationTime:Onset of Mixing

The clock starts ticking

Trituration: how we mix amalgam

Done with amalgamator or triturator

Activate the capsule and then put it in the amalgamator

Onset of Working

Placement and Condensation

Place the amalgam in your prep

Onset of Setting

Carving

When the material starts to set, you carve the amalgam

End of Setting

Material is very hard. Can’t manipulate it

24 hours

Polishing

Don’t polish until after 24 hrs

Steps:

Selection

Proportioning

Proportion of 2 components is set in capsule

Amalgamation

Chemical rxn

Manipulation

Your manipulation will influence the properties

Polishing

Question 4

Classifications\

___content = __ ___

We use ___ copper clinically right now

___ content = ___ ____

Particle ___ (and ___) = ____, ___

___of particle ___ = __,___

Materials with both components inside are called___

Answer 4

ClassificationsCopper content = low copper, high copper

We use high copper clinically right now

Zinc content = Zn-containing, Zn-free

Particle size (and shape) = irregular, spherical

Number of particle types = 1 or 2

Materials with both components inside are called mixed.

Question 5

Amalgamation

• Solution:
  
  • Mercury ___ and ____in the ___ ___
  • ___reaction
• Crystalization: ___ ___ ___ phases
  
  • Once two components mix together, ____ occurs
  • Different phases have started to form
  • Creates a ___
• Microstructure: ___ ____bonded to___
• Microstructure of the set amalgam is unreacted __ ___ ___ embedded in the ___ formed by the __ ___

Answer 5

AmalgamationSolution:

Mercury diffuses and dissolves in the surface particles

Surface reaction

Crystalization: AgHg, SnHg, CuSn phases

Once two components mix together, crystallization occurs

Different phases have started to form

Creates a matrix

Microstructure: unreacted particles bonded to matrix

Microstructure of the set amalgam is unreacted metal alloy powders embedded in the matrix formed by the chemical reaction

Question 6

Low-Copper Dental Amalgam

_____

__
___
____

There are different ways to describe the formula

___ ___ is mixed with ___

Gamma phase: ___ ___ ___. Still the powder

Gamma 1 phase: _____

___ AND ____

Gamma 2 phase: ____

Formed from ___ and ___

____ phase in this structure

_____ can happen along the gamma 2 phase

Normally long and penetrates throughout structure

If corrosion happens this wil ____ the __ ___.

Answer 6

Low-Copper Dental Amalgam

I/S-Alloy + Hg ® Residual Alloy + Matrix-1 + Matrix-2

Ag-Sn + Hg ® Ag-Sn + Ag-Hg + Sn-Hg

Ag3Sn + Hg ® Ag3Sn + Ag2Hg3 + Sn7-8Hg

Υ + Hg ® Υ +Υ1 + Υ2

There are different ways to describe the formula

Alloy powder is mixed with Hg.

Gamma phase: unreacted Metal alloys. Still the powder

Gamma 1 phase: Matrix 1

Silver and Mercury

Gamma 2 phase: Matrix 2

Formed from tin and mercury

Weakest phase in this structure

Corrosion can happen along the gamma 2 phase

Normally long and penetrates throughout structure

If corrosion happens this will weaken the structure greatly.

Question 7

High-copper Dental Amalgam:

____=___=____

Newer and improved version

Copper can react with ____ and then form a __ __

Physically the final setting is to eliminate the ____ ___almost completely

That is why this (new) phase will increase the ___ ___ of the amalgam

That is why high copper version is on the market right now

Answer 7

High-copper Dental Amalgam:

Ag3Sn (g) + Ag-Cu + Hg

= Ag2Hg3 (Υ 1) + Sn7-8Hg (Υ 2) + unreacted particles

= Cu6Sn5 (η’) + Ag2Hg3 (Υ 1) + unreacted particles

Newer and improved version

Copper can react with gamma 2 and then form a new phase

Physically the final setting is to eliminate the gamma 2 almost completely

That is why this (new) phase will increase the mechanical strength of the amalgam

That is why high copper version is on the market right now

Question 8

Composition of High Copper Alloy

Ag

Sn

Cu

Question 9

Mercury Proportions

Admixed - ___% mercury (Hg)

Spherical - ___% Hg

Alloy particles: irregular particles have ____ surface area requiring____mercury

Mercury proportions in those materials depends on what types of alloys you are using

This is a ___ reaction so the larger SA you have the___ Hg you will need

Sphere has ____ SA so requires less Hg.

Answer 9

Mercury Proportions

Admixed - 50% mercury (Hg)

Spherical - 43-46% Hg

Alloy particles: irregular particles have larger surface area requiring more mercury

Mercury proportions in those materials depends on what types of alloys you are using

This is a surface reaction so the larger SA you have the more Hg you will need

Sphere has smallest SA so requires less Hg.

Question 10

Microstructure

There are some ___ inside the material. We try to decrease the __ of ____ by doing condensation.

When dental amalgam fractures it fractures along the___ ____ inside the ___

So we try to minimize the amount of___in the material

Answer 10

Microstructure

There are some pores inside the material. We try to decrease the % of the pores by doing condensation.

When dental amalgam fractures it fractures along the unreacted powders inside the matrix

So we try to minimize the amount of matrix in the material

Question 11

Unset vs Set Material

Unset material:

The particles are embedded in the __ of ___

Purpose of Condensation is to remove excess Hg

Matrix forms eventually.

Answer 11

Unset vs Set MaterialUnset material: The particles are embedded in the sea of Hg

Purpose of Condensation is to remove excess Hg

Matrix forms eventually.

Question 12

Condensation

To ___ the ___ into the ___ ___

To attain the____ possible density (___ porosity)

To remove the ___ ___

During condensation the Hg rich layer will come on___

When you carve your restoration those layers will be___

Answer 12

Condensation

To compact the alloy into the prepared cavity

To attain the greatest possible density (reduce porosity)

To remove the excess mercury

During condensation the Hg rich layer will come on top.

When you carve your restoration those layers will be removed

Question 13

Effects of Delayed Condensation

Amalgam ___ ____

You are breaking the structure and that will break the material

Lower____ (harder to ____ material)

Difficult to ___ ___ ___

Lower ___, higher ___ of the material

Answer 13

Effects of Delayed CondensationAmalgam partially sets

You are breaking the structure and that will break the material

Lower plasticity (harder to manipulate material)

Difficult to remove excess mercury

Lower strength, higher creep of the material

Question 14

Physical PropertiesMetal

Thermal conductivity - ____

Coefficient of thermal expansion - ___ppm/ºC

• ___ than tooth structure

Electrical conductivity - ___

Radio____

It will be ___ on x-ray

Color - ___ ___ ____ (newly mixed material)

• __ ___
• Its diff then tooth color

Answer 14

Physical PropertiesMetal

Thermal conductivity - high

Coefficient of thermal expansion - 25 ppm/ºC

Higher than tooth structure

Electrical conductivity - high

Radiopacity

It will be light on x-ray

Color - Lustrous, shiny, white (newly mixed material)Metal white

Its diff then tooth color

Question 15

Creep

Creep is the __ ___ ___e under ___

___ ___ ___ on amalgam cause creep.

Clinically associated with a ___ of the ___ ____ of restoration.

We load our restorations everyday

Repeated load can cause this material to have dimensional change

When you do your prep in operative, we have 90degree angles in the margin.

Overtime the material will expand and roll over to the margin to create a very__ ___for the restoration

Under load that ___ can ___

This material has ___ creep if you don’t manipulate it well

This doesn’t necessarily mean there will be ___ ___

In clinic you need to distinguish between___ ___ __n and ___ __

Answer 15

Creep

Creep is the gradual dimensional change under load.

Repeated chewing forces on amalgam cause creep.

Clinically associated with a breakdown of the marginal integrity of restoration.

We load our restorations everyday

Repeated load can cause this material to have dimensional change

When you do your prep in operative, we have 90degree angles in the margin.

Overtime the material will expand and roll over to the margin to create a very thin margin for the restoration

Under load that margin can break

This material has high creep if you don’t manipulate it well

This doesn’t necessarily mean there will be secondary decay

In clinic you need to distinguish between marginal break down and secondary decay

Question 16

Properties of Dental Amalgam

Different clinicians prefer different material

Just preference

When you condense them you feel them differently

There really isn’t much difference

The compressive strength at 1 hour is very ___

So we tell patients “________________”

Wait until material completely sets. It will stand more load

Creep

High Copper is ___ ___ ___

All the red are in the standard

Answer 16

Different clinicians prefer different material

Just preference

When you condense them you feel them differently

There really isn’t much difference

The compressive strength at 1 hour is very lowSo we tell patients “don’t chew on this side for 24 hours”

Wait until material completely sets. It will stand more load

Creep

High Copper is not that much

All the red are in the standard

Question 17

ANSI/ADA Specification No. 1

Creep at 4 hr - __% max

Compressive strength at 1 hr - ___ MPa

Dimensional change at 24 hr - +/-__ mm/cm

Determination of “___ and ____”

Dental Amalgam has been used in dentistry for a long time

That’s why the first specification is on this material

It tells us the ___ requirements for this material

Doesn’t necessarily mean ____

Note: Higher strength doesn’t translate directly to better ___ ___

Answer 17

ANSI/ADA Specification No. 1

Creep at 4 hr - 3% max

Compressive strength at 1 hr - 80 MPa

Dimensional change at 24 hr - +/-20 mm/cm

Determination of “safety and efficacy”

Dental Amalgam has been used in dentistry for a long time

That’s why the first specification is on this material

It tells us the minimum requirements for this material

Doesn’t necessarily mean longevity

Note: Higher strength doesn’t translate directly to better clinical performance

Question 18

Clinical SignificanceAmalgam is generally considered a ___ material.

There is a certain requirement when we prep for those restorations

In operative class they will teach you how to prep

There are certain ____ for width, depth and now sharp angles

Answer 18

Clinical SignificanceAmalgam is generally considered a brittle material.

There is a certain requirement when we prep for those restorations

In operative class they will teach you how to prep

There are certain requirements for width, depth and now sharp angles

Question 19

Galvanic Effect

When two metallic restorations consisting of metals with different degrees of _____are placed in close proximity, it is possible that a galvanic ___l will be set up.

The resultant currents can

Cause ___ ___

Leave a ___ ___ ___ in the mouth

Accelerate the ____ ______ of the ___ electronegative metal.

Answer 19

Galvanic Effect

When two metallic restorations consisting of metals with different degrees of electronegativity are placed in close proximity, it is possible that a galvanic cell will be set up.

The resultant currents can

Cause patients discomfort

Leave a strong metallic taste in the mouth

Accelerate the corrosive breakdown of the more electronegative metal.

Question 20

Corrosion and Tarnish

Corrosion is the ____ of metals in the mouth and affects the ___ of the____

May also result from ___ ____ in foods or saliva.

Corrosion products ___ ____

Affects the ___ ____ of the material

Tarnish is a ___ ___of ___ ___.Tarnish is ___ but does ___ ____ amalgam (corrosion does).

Tarnish doesn’t influence the ___ of the ___

Mechanical property of material is __ ___. It just looks ugly

Old amalgam looks ___

They both occur more on amalgam with ___ ___

____ is necessary to avoid them.

Answer 20

Corrosion and TarnishCorrosion is the dissolution of metals in the mouth and affects the body of the amalgam.

May also result from chemical attack in foods or saliva.

Corrosion products seal margins

Affects the mechanical property of the material

Tarnish is a surface reaction of surface discoloration.Tarnish is unesthetic but does not destroy amalgam (corrosion does).

Tarnish doesn’t influence the body of the amalgam

Mechanical property of material is still good. It just looks ugly

Old amalgam looks black

They both occur more on amalgam with rough surfaces

Polishing is necessary to avoid them.

Question 21

Carving and Polishing

After carving you need to polish the material

Need to bring patient back

Gives ____ to the amalgam

Answer 21

Carving and Polishing

After carving you need to polish the material

Need to bring patient back

Gives longevity to the amalgam

Question 22

Clinical Performance

Longevity

___ yrs ideally, ___ yrs practically

Depends on situation. How you place them? Patient bite force? Cavity size?

Modes of failure

___, ___ ___, ___ ___

Main reason is ___

If your prep is good, the material doesn’t ___ as ___.

Theoretically this material will last 20-25 yearsPractically, because of manipulation and we cant achieve the ideal properties (sometimes we can)

Usually lasts only about 10 years

This is ___ the longevity of dental composites

Answer 22

Clinical PerformanceLongevity

20-25 yrs ideally, 8-12 yrs practically

Depends on situation. How you place them? Patient bite force? Cavity size?

Modes of failure

caries, margin fracture, bulk fracture

Main reason is decay!

If your prep is good, the material doesn’t fracture as easily.

Theoretically this material will last 20-25 yearsPractically, because of manipulation and we cant achieve the ideal properties (sometimes we can)

Usually lasts only about 10 years

This is double the longevity of dental composites

Question 23

Advantages of Dental Amalgam

___

___ ___

___ to ___

• Less ___ ___
• ____

Takes ____ ____ for you to place than composites most of the time

Disadvantages of Dental Amalgam

Un____

Requires ___ ___ ___

____ (very rare)

___ __/____

Concerns about ___ ____

Answer 23

Advantages of Dental Amalgam

Durable

Cost effective

Easy to use

Less technique sensitive

Forgiveness

Takes less time for you to place than composites most of the time

Disadvantages of Dental Amalgam

Unaesthetic

Requires Complex tooth preparation

Allergy (very rare)

Galvanic effect / conductivity

Concerns about mercury toxicity

Question 24

• Biological Properties
• Mercury Toxicity:
  
  • OSHA maximum threshold limit value TLV = __ mg/m3 (vapor) per __ hr work week.
  • Transient intraoral release (___ mg/m3).
• Mercury Hypersensitivity_____ evel allergic reaction.
  
  • Very rare
  • Estimated to be < 1 / ______
• Amalgam Tattoo:
  
  • Can occur during ___ ___ if no ___ ____
  • Embedded amalgam particles ___ and locally ___ gum.
  • No known ___ ___
  • Its just not ___
  • You can see black spots on ___ or on ___
  • Those are caused by small pieces of amalgam
  • When you do restoration those amalgam pieces get into the___ ___ and then just stay there
  • Just esthetically this doesn’t look good

Answer 24

Biological PropertiesMercury Toxicity:

OSHA maximum threshold limit value TLV = 50 mg/m3 (vapor) per 40 hr work week.

Transient intraoral release (<35 mg/m3).

Mercury Hypersensitivity:Low level allergic reaction.

Very rare

Estimated to be < 1 / 100,000,000

Amalgam Tattoo:

Can occur during amalgam removal if no rubber dam.

Embedded amalgam particles corrode and locally discolor gum.

No known adverse reactions.

Its just not esthetic

You can see black spots on mucosa or on gingiva

Those are caused by small pieces of amalgam

When you do restoration those amalgam pieces get into the soft tissue and then just stay there

Just esthetically this doesn’t look good

Question 25

• Mercury is a highly toxic element; there is __ __ __ __ of exposure.
• Type of Hg
  
  • ___ Hg (Hg ___)
  • ___ Hg
  • ___Hg (___mercury and __ mercury)
• Mercury is ___-, ___-, and ____toxic.
• Multiple ___ ___ can be affected.
• Mercury is ___s and ___
• Found everywhere

Answer 25

Mercury is a highly toxic element; there is no known safe level of exposure.

Type of Hg

Elemental Hg (Hg vapor)

Inorganic Hg

Organic Hg (methylmercury and ethyl mercury)

Mercury is neuro-, nephro-, and immunotoxic.

Multiple organ systems can be affected.

Mercury is ubiquitous and persistent.

Found everywhere

Question 26

World Health Organization (WHO) estimated __ µg total mercury is taken up per day.

WHO recommends the maximum acceptable daily intake (ADI) of mercury to be __μg.

Answer 26

World Health Organization (WHO) estimated 6.6 µg total mercury is taken up per day.

WHO recommends the maximum acceptable daily intake (ADI) of mercury to be 40 μg.

Question 27

Sources of Hg

• __
• __
• ___
• ____

For us and other industries

*Seafood once per week - ___x more exposure than from dental amalgam.

Answer 27

Sources of Hg

Food

Water

Air

Occupational exposure

For us and other industries

*Seafood once per week - 2-8x more exposure than from dental amalgam.

Question 28

Dental amalgam: ___ ___ ( ____ )

We have pure mercury in the capsule

Released during __ ___ involving amalgam in ___ quantities

___ free mercury is left in the __ ___

Once the amalgam is set there is not free mercury left in there.

No free mercury is released into the oral environment during ___

Answer 28

Dental amalgamMercury vapor (Elemental)

We have pure mercury in the capsule

Released during all procedures involving amalgam in minute quantities

No free mercury is left in the set amalgam

Once the amalgam is set there is not free mercury left in there.

No free mercury is released into the oral environment during corrosion

Question 29

Amalgam Safety in Children

507 children (228 females and 279 males)

Posterior restorations either in dental amalgam or resin composite

A mean of 8.3 surfaces restored with amalgam

7 years of follow-up

Neurological hard signs (NHSs)

Concl: No statistically significant ___ in ___s was observed between the 2 groups in any year.

The results of this study demonstrate that exposure to mercury from dental amalgam does NOT adversely affect ___ ___ in children.

When the additional factor of the _____ longevity of amalgam was compared with composite, the continued viability of amalgam as a restorative material is confirmed.

This material has better longevity than composites

Answer 29

Amalgam Safety in Children

507 children (228 females and 279 males)

Posterior restorations either in dental amalgam or resin composite

A mean of 8.3 surfaces restored with amalgam

7 years of follow-up

Neurological hard signs (NHSs)

Concl: No statistically significant difference in NHSs was observed between the 2 groups in any year.

The results of this study demonstrate that exposure to mercury from dental amalgam does NOT adversely affect neurological development in children.

When the additional factor of the greater longevity of amalgam was compared with composite, the continued viability of amalgam as a restorative material is confirmed.

This material has better longevity than composites

Question 30

ADA Statement On Dental Amalgam - (2009)

Dental amalgam is considered a ___, ___ and____material that has been used to restore the teeth of more than ___ ____Americans.

Overall, studies continue to support the position that dental amalgam is a ___ restorative option for both children and adults. When responding to safety concerns it is important to make the distinction between ___n and ___ risks.

Answer 30

ADA Statement On Dental Amalgam - (2009)

Dental amalgam is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans.

Overall, studies continue to support the position that dental amalgam is a safe restorative option for both children and adults. When responding to safety concerns it is important to make the distinction between known and hypothetical risks.

Question 31

FDA Issued a Final Rule (2009)

(1) Reclassified mercury from a class I (___ risk) device to class II (__ ___) device;
(2) Classified dental amalgam as a class __ device;
(3) Designated a special ___ ___ document for dental amalgam.

Exposures to mercury vapor from dental amalgam do __ put individuals age __ and older at ___for mercury-associated adverse health effects.

Answer 31

FDA Issued a Final Rule (2009)

(1) Reclassified mercury from a class I (least risk) device to class II (more risk) device;
(2) Classified dental amalgam as a class II device;
(3) Designated a special controls guidance document for dental amalgam.

Exposures to mercury vapor from dental amalgam do NOT put individuals age six and older at risk for mercury-associated adverse health effects.

Question 32

WHO Report (2010)

Dental amalgam remains a dental restorative material of choice and it is a ___ and __ choice.

___ a call from those opposed to the continued availability of amalgam to ban its use, instead opting for a “___ ___” of the material in hopes that improved ___ efforts worldwide will eventually decrease the need for all restorations.

Answer 32

WHO Report (2010)

Dental amalgam remains a dental restorative material of choice and it is a safe and viable choice.

Rejected a call from those opposed to the continued availability of amalgam to ban its use, instead opting for a “phase down” of the material in hopes that improved prevention efforts worldwide will eventually decrease the need for all restorations.

Question 33

General Mercury Hygiene Recommendations

__ __ ___ involved in the ____of mercury and dental amalgam regarding the potential hazards of mercury vapor and the necessity of observing good mercury hygiene practices.

Remove professional ___ before ___ the workplace.

Answer 33

General Mercury Hygiene Recommendations

Train all personnel involved in the handling of mercury and dental amalgam regarding the potential hazards of mercury vapor and the necessity of observing good mercury hygiene practices.

Remove professional clothing before leaving the workplace.

Question 34

Office Engineering

Work in ___ ___ work area

Use proper work area design to facilitate __ ___ and ___. Floor coverings should be ____, ___ and ___ to ___

Carpet is not recommended because its impossible to clean contamination

Periodically ___ the dental operatory atmosphere for mercury vapor.

Answer 34

Office Engineering

Work in well-ventilated work area

Use proper work area design to facilitate spill containment and cleanup. Floor coverings should be nonabsorbent, seamless and easy to clean.

Carpet is not recommended because its impossible to clean contamination

Periodically check the dental operatory atmosphere for mercury vapor.

Question 35

Mercury Hygiene during Manipulation

Use only ____alloys and stock a variety of capsule ____

So you can use just enough and not waste anything

Use an ___with a completely ___ ___.

If possible, ___ single-use capsules after use, ___them in a ____ container and recycle them.

Use care when handling amalgam. Avoid ___ ___ with mercury or freshly mixed amalgam.

Use ___ ___ ___ ___ (fitted with___ or ____) when ___ or ___ amalgam.

Use ___ water spray and ___ when grinding or removing amalgam;

Use chair side ___ and ___ ___ ___

Salvage amalgam___ and store under ___ (___, ___ or ________) for recycle.

Small spills can be cleaned safely using commercially available___ ___ ___

Just use those kits and nothing else

Never use a ___ or a____ to clean up the mercury.

Never use a ___ ___ of any type to clean up the mercury.

Never use ___ ___ ___ to clean up the spill, particularly those containing __ or___

Never pour mercury, or allow it to go, ___ the ___

Never allow people whose shoes may be contaminated with mercury to __ ___ or leave the spill area until the mercury-contaminated items have been removed.

Answer 35

Mercury Hygiene during ManipulationUse only precapsulated alloys and stock a variety of capsule sizes.

So you can use just enough and not waste anything

Use an amalgamator with a completely enclosed arm.

If possible, recap single-use capsules after use, store them in a closed container and recycle them.

Use care when handling amalgam. Avoid skin contact with mercury or freshly mixed amalgam.

Use high-volume evacuation systems (fitted with traps or filters) when finishing or removing amalgam.

Use cold water spray and suction when grinding or removing amalgam;

Use chair side traps and vacuum pump filters

Salvage amalgam scrap and store under solution (water, glycerin or sodium thiosulfate) for recycle.

Small spills can be cleaned safely using commercially available mercury cleanup kits

Just use those kits and nothing else

Never use a broom or a paintbrush to clean up the mercury.

Never use a vacuum cleaner of any type to clean up the mercury.

Never use household cleaning products to clean up the spill, particularly those containing ammonia or chlorine.

Never pour mercury, or allow it to go, down the drain.

Never allow people whose shoes may be contaminated with mercury to walk around or leave the spill area until the mercury-contaminated items have been removed.

Question 36

In a typical amalgam procedure,

__% Hg in cotton rolls/capsules

__% trituration surplus

__% collected by high vacuum suction

__% amalgam restoration

Answer 36

In a typical amalgam procedure,

4% Hg in cotton rolls/capsules

15% trituration surplus

33% collected by high vacuum suction

48% amalgam restoration

Question 37

Environment ProtectionRelease of mercury to the environment

__% from combustion of fuels for energy production

__% from combustion of waste

__% manufacturers and consumers

___% dentistry

Answer 37

Environment ProtectionRelease of mercury to the environment

53% from combustion of fuels for energy production

34% from combustion of waste

13% manufacturers and consumers

<1% dentistry

Question 38

Best Management Practices for Amalgam Waste

Use chair side __; inspect and ___ traps

Install amalgam ___

Can collect more than ___% of excess amalgam

Amalgam separators are devices designed to ___ amalgam waste particles from dental office ____. Without an amalgam separator, these particles can be suctioned into the dental unit vacuum line and discharged into the __ __ __

Very ___

Not mandatory in Texas. Just a recommendation.

Use high __ ___

Recycle or use a commercial waste __ ___to dispose of the collected amalgam

Answer 38

Best Management Practices for Amalgam Waste

Use chair side traps; inspect and clean traps

Install amalgam separators

Can collect more than 99.5% of excess amalgam

Amalgam separators are devices designed to remove amalgam waste particles from dental office wastewater. Without an amalgam separator, these particles can be suctioned into the dental unit vacuum line and discharged into the public sewer system.

Very expensive

Not mandatory in Texas. Just a recommendation.

Use high vacuum suction

Recycle or use a commercial waste disposal service to dispose of the collected amalgam

Question 39

Minamata Convention on Mercury (2013)

The United Nations Environmental Program (UNEP) International Negotiating Committee (INC) completed negotiations on an agreement for a global, legally-binding treaty on mercury.

The agreement contains provisions for the ____ of dental amalgam including ___ dental ___ into alternatives.

IADR participated and contributed to the negotiations, along with FDI World Dental Federation and the International Dental Manufacturers, and has advocated for a reduction in the use of dental amalgam (versus a ban) through increased attention to dental ___ and ___ ___, increased research and development on alternatives, and best management techniques for amalgam waste.

It doesn’t say a ban.

There isn’t any other material to replace amalgam in certain situations!

Dental composites cant be used for everything!

Answer 39

Minamata Convention on Mercury (2013)

The United Nations Environmental Program (UNEP) International Negotiating Committee (INC) completed negotiations on an agreement for a global, legally-binding treaty on mercury.

The agreement contains provisions for the reduction of dental amalgam including increased dental research into alternatives.

IADR participated and contributed to the negotiations, along with FDI World Dental Federation and the International Dental Manufacturers, and has advocated for a reduction in the use of dental amalgam (versus a ban) through increased attention to dental prevention and health promotion, increased research and development on alternatives, and best management techniques for amalgam waste.

It doesn’t say a ban.

There isn’t any other material to replace amalgam in certain situations!

Dental composites cant be used for everything!