Influence of amalgam, alloy, and Hg on the in vitro growth of Streptococcus mutans: III. Effect of specimen age and composition.

We will now summarize the conclusions from parts I, II and III of this study. A test procedure has been developed that provides a simple, quick, and nondestructive means of monitoring the in vitro growth of S mutans in the presence of amalgams and alloys. The spectrophotometric readings are related in a simple way to growth expressed as dry weight of bacteria and metabolic products. Results are expressed as growth relative to controls which represent bacteria growing under identical conditions but not in contact with metals. The %RA60 value that represents growth after 60 hours relative to controls is used as a measure of growth in the presence of alloys or amalgams. Spherical, fine cut, and dispersion alloys were studied as well as amalgams prepared from these alloys. The dispersion alloy inhibits growth less than the spherical alloy which in turn inhibits growth less than the fine cut alloy. The results for amalgams prepared from the alloys are reversed. At an aging time of two hours, dispersion alloy amalgams inhibit growth more than spherical alloy amalgams and fine cut alloy amalgams. Aging time of amalgams greatly influences the growth inhibition. Immediately after trituration growth is inhibited, but this inhibition is lost with aging. Different types of amalgams seem to lose growth inhibition at different rates. Hg composition in the range of 48 to 52% seems to have little effect on growth inhibition. It remains for clinical studies, which are concerned with the incidence of secondary caries associated with amalgams, to demonstrate that the age and nature of the amalgam are significant.