Replacing Amalgam Restorations: A Standardized Protocol Based on Analyzing Tissue Physicochemical Modifications.

Almost 60% of operative dentistry is devoted to replacing restorations. When practitioners have to replace an amalgam restoration, they tend to opt for an adhesive restoration, as it is conservative of tooth tissues and mimics the natural appearance of teeth. Based on a literature review, the aim of this article is to determine the best tissue approach when replacing an old amalgam by a new adhesive restoration. After analyzing and understanding tissue alterations due to the amalgam corrosion process, the authors propose an analytical approach to managing the situation. Both tissue orientated and specific mechanical approaches are developed and should be implemented to carry out the optimal clinical procedure and achieve the most conservative and durable treatment.