Clinical and Radiographical Assessment of Alveolar Bone Loss Associated with Overhang Amalgam Filling

Tooth periodontium are vital structures and affected by the surrounding environments. Overhang amalgam restoration usually results in fracture of the restoration or deteriorated periodontal health. The aim of this study was to report the prevalence of overhang amalgam restorations and to measure the clinical attachment level and alveolar bone loss in overhang surface with comparison to the control intact surface of the same tooth by using digital panoramic radiography.

Up to 900 digital panoramic radiographs were evaluated for the presence of overhang amalgam, only 80 overhangs filling detected, the clinical attachment level was measured clinically, and the alveolar bone loss was measured radiographically for overhang surface of the tooth and compared with control normal surface of the same tooth.

The prevalence of overhang amalgam was 3.2%, more in mandible and in first molars, the alveolar bone loss and clinical attachment level increased with overhang filling (4.313 mm and 3.731 mm respectively) compared to normal surface (1.9 mm and 1.4 mm respectively) and the difference was statistically significant. The alveolar bone loss was higher in male while clinical attachment level was higher in female, but the differences were statistically non-significant. Mandibular teeth had statistically significant higher bone loss and clinical attachment level than maxillary teeth.

Clinical and radiographical examinations play an important role in the diagnosis of periodontal problems as well as measurements of clinical attachment level and bone loss associated with overhang filling which should be avoided as much as possible to maintain the periodontal health and prevent any further destruction.