Following the global agreement under the Minamata Convention on Mercury, and its subsequent ratification by governments, there is now widespread commitment to phasing down, and ultimately eliminating, the use of dental amalgam. This shift underscores the urgent need to evaluate the clinical efficacy and broader impact of mercury-free restorative alternatives. 

We conducted a Cochrane overview, published in the Cochrane Library in July 2026, to summarise the evidence from systematic reviews evaluating the clinical effectiveness and longevity of restorative materials for direct-placement coronal restoration in the permanent posterior dentition.

We also summarised the evidence from economic studies for the cost-effectiveness of these materials.

This Cochrane overview is relevant to all countries, including those that have commenced their own phase-down/phase-out schedule.

You can read an Executive Summary of the evidence here, or a plain language summary here.

The full report is available on the Cochrane Library: Lewis SR, Walsh T, Glenny AM, Banerjee A, Boyers D, Hatton PV, Mackie C, Martin N, Palin WM, Pritchard MW, Quinn BM, Ramsay CR, Ricketts D, Riley P, Clarkson JE. Restorative materials for direct coronal restoration of permanent posterior teeth: an overview of systematic reviews. Cochrane Database of Systematic Reviews 2026, Issue 7. Art. No.: CD06279. DOI: 10.1002/14651858.CD016279