Dental Pluggers and Condensers (Amalgam Condensers)

Key points

• Condenser and plugger mean the same instrument in restorative dentistry; endodontic pluggers are a separate, much finer group.
• A smaller face concentrates the same hand force into a higher pressure, which is why condensation starts with the small end.
• Serrated faces grip the amalgam and bring mercury-rich material to the surface, where it's carved away.

What is a plugger used for in dentistry?

A plugger packs a plastic restorative material into the cavity so it fills every corner, adapts to the walls and contains no air. With amalgam, condensation also does a second job: firm, overlapping strokes push the mercury-rich phase towards the surface of each increment, where it's removed when the cavity is overfilled and carved back, leaving a stronger, lower-mercury restoration. With packable composite and glass-ionomer, a condenser presses the material against the walls and the matrix, and with temporary materials it simply packs them down.

Pluggers follow the amalgam carrier, which delivers the material, and come before the burnisher and the carver. The amalgam restorative instruments guide shows the condenser alongside the rest of the amalgam family, and the restorative instruments hub gives an overview of the group.

What types of condenser and plugger are there?

Condensers differ in the shape of the face, the texture of the face and the angle of the shank.

What is the difference between a smooth and a serrated condenser?

A serrated face has a fine cross-hatched pattern that grips the amalgam, so the instrument doesn't skid over the increment and each stroke pulls a little of the soft, mercury-rich matrix to the surface. A smooth face slides more easily and leaves a flatter surface, which suits the last increments, the margins and materials such as composite and glass-ionomer that would tear on a serrated face. Many clinicians use a serrated condenser for the bulk of an amalgam and a smooth one, or a burnisher, to finish.

Which plugger size should you use?

Start with the smallest plugger that covers the area and work up. In a 1995 study in the European Journal of Oral Sciences, A. Lussi and colleagues measured how 44 dentists condensed amalgam in their own practices, using a force-sensing plugger: peak pressure was about 8.9 MPa with a small plugger and 5.5 MPa with a large one, and average pressures were 3.7 and 2.2 MPa. They also found that practitioners condensed with less pressure than is often recommended. The same hand force spread over a larger face simply packs less. The same study found that filling a cavity took about 131 seconds on average, of which only about 44 seconds were spent actually condensing, and the shape of the alloy particles made no significant difference to the pressure used.

The alloy still changes how the material feels under the plugger. Phillips' Science of Dental Materials notes that amalgams made from lathe-cut or admixed powders resist condensation more than all-spherical ones, and that freshly mixed spherical amalgam is so plastic that condensation pressure can't be relied on to build the proximal contour of a Class II filling, so a well-adapted, wedged matrix has to do that work.

How do you condense an amalgam restoration?

Condense in small increments, each one straight after it's carried in. Begin in the proximal box: press the first increment into the gingival corners with a small plugger, directing the force down onto the floor and sideways against the walls and the matrix band, so the contact area is filled before the occlusal part. Overlap each stroke with the last and use firm, steady pressure from a finger rest. Move to a larger plugger as the cavity fills, overfill slightly, and remove the mercury-rich top layer when you start to carve.

Work quickly, because amalgam that has started to set no longer bonds to the next increment and leaves layers and voids. Don't use a plugger that is too large to reach the corners, and don't let it rock on the margins, which can chip the enamel. For composite, use the coated pluggers on the composite instruments page; the amalgam restoration tray setup shows where condensers sit on the tray.

What is the difference between a restorative and an endodontic plugger?

A restorative plugger packs filling material into a cavity in the crown; an endodontic plugger compacts gutta-percha inside the root canal. Endodontic pluggers have long, slender working ends, often only a few tenths of a millimetre across and sometimes marked with depth rings, and they're used with vertical pressure on softened gutta-percha, while spreaders, which are tapered and pointed, are used for lateral compaction. They're covered on the endodontic hand instruments page and in the endodontic instruments guide. Bone condensers used to compact bone at implant sites are different again and belong with osteotomes.

What does the Equate range include?

Equate's condensers run from fine 0.7/1.0 mm restorative pluggers to 2.5/3.8 mm double-ended pluggers. They include cylindrical pluggers in 1.0/1.5, 1.2/2.0 and 1.8/2.5 mm on light-blue silicone handles, three titanium pluggers from 1.0/1.3 to 1.8/2.5 mm, form condensers in 1.5/2.5 mm and a drop-shaped non-stick 1.3/1.8 mm form condenser, silicone-handled condensers, a cement stopper, four base carrier-condensers with rigid or malleable tips, two amalgam stoppers, three plain compactors on hollow handles, a form condenser-burnisher and a non-stick packer-modeller for composite.

Every instrument is passivated stainless steel, ultrasonically cleaned, shape-, boil- and performance-tested and individually packed. Clinics can request samples and a quote.

How do you clean and care for pluggers?

Remove amalgam from the face before it hardens, paying attention to serrations, which trap material; a soft brush during cleaning reaches into the pattern. Collect amalgam residue as amalgam waste. Amalgam condensers are the CDC's own example of a semicritical instrument, one that touches the mouth without penetrating tissue, and its disinfection guideline recommends sterilising them after each use when they are heat-tolerant. Then clean, inspect and sterilise in line with the manufacturer's ISO 17664-1 instructions and the CDC's Guidelines for Infection Control in Dental Health-Care Settings or, in UK practices, HTM 01-05. Replace a plugger whose face has become rounded, chipped or worn smooth, because a damaged face no longer packs evenly.

Equate Dental Pluggers and Condensers (Amalgam Condensers) options

Dental Plugger 1.8 / 2.5 mm Titanium

EI-0016

Double-Ended Filling Plugger 2.5 mm / 3.8 mm - Hollow Handle

EI-0017

Dental Plugger 1.3 / 1.8 mm Titanium

EI-0018

Dental Plugger 1.0 / 1.3 mm Titanium

EI-0019

Amalgam Stopper

EI-0087

Amalgam Stopper

EI-0088

Plugger 1.0mm/2.0mm - Double-Ended Knurled Handle

EI-0089

Plugger 2.0 / 2.5 mm Knurled Handle

EI-0095

Fine Plugger 0.7mm/1.0mm - Knurled Handle

EI-0096

Cement Stopper - Solid Handle

EI-0158

Form Condenser 1.5-2.5 mm

EI-0927

Non-Stick Packer-Modeller

EI-0936

Buying in your market

• UK & Ireland
• North America
• DACH
• Nordics & Scandinavia
• Baltics
• GCC
• Turkey

Frequently asked questions

References

1. Lussi A, Brunner M, Portmann P, Buergin W. Condensation pressure during amalgam placement in patients. European Journal of Oral Sciences 1995;103(6):388–393
2. Heymann HO, Swift EJ, Ritter AV (eds). Sturdevant's Art and Science of Operative Dentistry, 6th ed. Elsevier, 2013 (amalgam restorations: condensation)
3. Hargreaves KM, Berman LH (eds). Cohen's Pathways of the Pulp. Elsevier (obturation instruments)
4. Kohn WG, et al. Guidelines for Infection Control in Dental Health-Care Settings, 2003. MMWR 52(RR-17), Centers for Disease Control and Prevention
5. ISO 17664-1:2021 Processing of health care products: information to be provided by the medical device manufacturer for the processing of medical devices, Part 1: critical and semi-critical medical devices
6. Boyd LB. Dental Instruments: A Pocket Guide, 7th edition. Saunders/Elsevier, 2020. Chapter 8, Amalgam Restorative Instruments (photographs used under licence)
7. Centers for Disease Control and Prevention. Guideline for Disinfection and Sterilization in Healthcare Facilities (2008): disinfection of healthcare equipment
8. Sakaguchi RL, Ferracane JL, Powers JM (eds). Phillips' Science of Dental Materials. Elsevier (chapter 15, dental amalgams)

Related

• Restorative Dental Hand Instruments
• Amalgam Carriers (Dental Amalgam Carriers)
• Dental Burnishers: Ball, Football, Acorn, T-Ball and Beavertail
• Endodontic Hand Instruments
• Dental Composite Instruments: Placement, Sculpting and the Composite Gun
• Amalgam Restoration Tray Setup
• Amalgam Restorative Instruments: What Each One Does
• Dental Carvers: Types of Carvers in Dentistry and the Lab
• Tofflemire and Other Matrix Band Retainers

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