Failure of Amalgam Restoration: Post-restoration Hypersensitivity


In this article, we explain briefly the main causes of Pain that is associated after placment of an Amalgam Dental Restoration, its Clinical picture and its treatment.

Post-restoration Hypersensitivity

Post-restoration HypersensitivityIt may result due to irritation during cavity preparation (Trauma, pressure, vibration, heat generation and desiccation) &/or irritation from the restoration.



Hypersensitivity in a recently amalgam restored tooth may be generated by stimulation of freshly exposed permeable virgin dentin surface by:

  1. Galvanic Stimuli generated on immediate contact with opposing dissimilar metals.
  2. Thermal: Thermal stresses conducted through large no isolated metallic restorations.
  3. Chemical and osmotic: Stimuli by osmotic fluids that penetrate through leakage, hairy crack or fracture in the tooth or restoration.
  4. Tactile: Pressure of premature contact.
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Clinical picture

  • Severe pain occurring after insertion of a restoration mostly indicates pulp involvement following microscopic exposure.
  • If pain occurs on thermal stimulation and continues long after removal of stimulus, it suggests pulp pathology as pulpitis.
  • Pain on cold application indicates reversible pulpitis.
  • If it results from biting, it suggests periodontal involvement, premature contact or fractured restoration.
  • Dull aching pain several days after insertion of restoration may be due to delayed expansion of amalgam after moisture contamination of zinc containing amalgam.


  1. Prevention by dentin sealing with cavity varnishes, liners or bases.
  2. Elimination of occlusal interference and pre-mature contacts.
  3. Pulp involvement by exposure or advanced pulpitis is treated with root canal treatment.


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About Author

MohsenSaeedOzaibi, A Dentist, Dental Manager at Emirates Jordanind Medical Center, Founder of Graduated in 2009 with a Bachelor's Degree in Dental Science from Misr International University. A veteran in digital dental content publishing and marketing.

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