Ideal Direct Posterior Restoration: Yellow / Black / White - A Review

The quest to search an ideal direct posterior restorative material has been a challenge for researchers and fraternities in Restorative Dentistry. At one point, gold alloy and pure gold were considered to be the ideal in direct and indirect posterior restorations and over time it was replaced due to its cost factor by other successors. Silver Amalgam has been the traditional material for filling cavities in posterior teeth for the last 150 years and due to its effectiveness and cost, amalgam is still the material of choice in dentistry. As tooth-coloured direct resin-based composite restorations and glass ionomer restorations have become popular with the lay public, clinicians rarely offer gold restorations as an option to patients. The simple fact that tooth-coloured restorations offer better aesthetic results seems to imply that they are superior in other aspects such as strength, wear and longevity. This misconception has led to abuse of the currently available aesthetic materials, cessation of proven techniques of cavity preparation and general ignorance of the shortcomings of the new and reportedly improved direct posterior restorations. The purpose of this article is to discuss about the most popular direct posterior restoratives – Direct Filling Gold, Silver Amalgam, Glass ionomer cement and Resin-based Composites – and provide direction on how they are best used within current limitations.