Two premolars with old amalgam fillings, restored with composite overlays: five-year follow-up
The upper right premolars had old, worn amalgam fillings. We replaced them with direct composite overlays covering the biting surfaces, and five years later they are still working and look natural.
Before
The upper right premolars had old amalgam fillings: dark metal, worn margins, and thin tooth walls around them.
Treatment
Instead of crowns, we removed the amalgam and restored both premolars directly with composite, covering the biting surfaces (direct overlays) to protect the thin walls.
Five years later
The restorations are still stable, with the natural shape and colour of the teeth.
Clinical details for dentists
1 Before: old amalgam restorations on the premolars (14, 15) 2 5-year follow-up: direct composite overlays on 14 and 15
Case summary
Upper right first and second premolars (14, 15) with old amalgam restorations and thin remaining cusps.
Treatment
- Amalgam removal under isolation.
- Direct composite overlays with cuspal coverage.
Follow-up
5 years: restorations intact and functioning, natural form and shade.
Take-home message
Direct cuspal coverage with composite is a conservative, durable alternative to crowns when walls are thin.
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