retention features may be prepared within the amalgam restoration to provide mechanical retention for the com- posite material
• ensure adequate moisture control by applying a rubber dam or judicious use of cotton wool rolls and salivary
Clinical, Cosmetic and Investigational Dentistry 2014:6
ejectors; either way, it is essential to achieve good
moisture isolation
• prepare the adjacent amalgam and tooth tissue surfaces
using either an intraoral aluminum oxide sandblaster
(Microetcher) or a diamond bur
• if indicated, provide any necessary pulp protection
according to contemporary regimes
• acid etch the tooth tissue surfaces for 15–30 seconds
and thoroughly wash and dry the preparation using a
three-in-one syringe
• apply an adhesive bonding system to the conditioned tooth
surfaces according to the manufacturer’s directions
• apply an alloy-resin bonding agent (eg, Alloy Primer, Kuraray) to the prepared amalgam surface according to
manufacturer’s directions
• as an optional step, a visible light-cure resin opaquer
(eg, Visiogem, 3M ESPE) may be applied to the conditioned amalgam surface to mask the amalgam surface; the opaquer has a chemistry similar to that of the resin composite, and it chemically bonds to the alloy-resin bonding agent and resin composite material
• place the repair composite using an incremental technique, light-curing each increment fully prior to applying subsequent layers of material
• carefully contain and finish the repair, taking care to have burs and finishing devices work from composite to the amalgam
• check the occlusion and remove any occlusal interfer- ences present.