Evaluation of effect of amalgam & composite interproximal restoration on periodontal health- A clinical, radiographic & immunochemical study

Background: The integrity of periodontal tissues is fundamental to maintaining oral function, aesthetics, and overall dental health. Restorative materials such as amalgam and composite, commonly used in interproximal restorations, can influence periodontal health through their physical and chemical characteristics. Factors such as surface roughness and potential for plaque accumulation may contribute to local inflammation and tissue degradation. Proinflammatory cytokine levels increase in response to such stimuli, and gingival crevicular fluid (GCF) analysis offers a non-invasive means to evaluate localized immunoinflammatory responses.Aims and Objectives: To clinically and radiographically compare the effects of interproximal amalgam and composite restorations on periodontal health, and to quantify the expression of inflammatory biomarkers—IL-1α, IL-6, and RANKL:OPG—in GCF at baseline, 3 months, 6 months, and 12 months.Materials and Methods: 32 patients requiring Class II restorations were enrolled. After baseline periodontal examination (PI, GI, PPD, CAL), restorations were placed using either amalgam or composite material. GCF samples were collected using Periopaper strips for cytokine analysis. Intraoral periapical radiographs (IOPA) with a grid were used to measure the distance between the restoration and alveolar bone crest. Clinical, radiographic, and immunochemical parameters were re-evaluated at 3 (T3), 6 (T6), and 12 (T12) months.Results: Both restoration types showed increases in PI, GI, PPD, CAL, cytokine levels, and restoration-to-bone crest distance over time. However, the amalgam group exhibited significantly greater changes across all parameters compared to the composite group.Conclusion: Subgingival and juxtagingival restorations, even when properly contoured, may impair periodontal tissue healing at both clinical and molecular levels. These effects are more pronounced with amalgam restorations and persist up to one year post-treatment.