Composite filling replacing an amalgam with decay beneath

Patient concern

An old silver filling the patient wanted replaced, with decay found underneath on assessment.

Clinical assessment

Decay had progressed beneath the existing amalgam at the margins. Replacing the filling for appearance alone would have left the underlying problem in place, so the decision was driven by the diagnosis rather than by the colour of the old restoration.

Treatment rationale

The amalgam and the decay beneath it were removed, and the tooth was rebuilt in bonded composite in layers so the anatomy and the contact point with the neighbouring tooth were restored. Bonded composite also allows more of the sound tooth to be retained than a full crown would.

Treatments used

• Composite bonding
• Restorative dentistry