Objective: Conservative restoration principles that accurately reduce plaque accumulation are the goals of restorative dentistry. Correct and perfect restoration has an important effect on health of periodontious tissues. This study was done to compare the methods of oral hygiene, over hanged removal and restoration changing on periodontal health and alveolar bone height of restored mandible molars with proximal over hanged amalgam. Materials and Methods: All patients with over hanged amalgam restoration were randomly divided into three groups. In order to survey the effect of over hanged removal on gingival and bleeding indices and alveolar bone height adjacent to mandible molar teeth, these indices were determined according to recurrent radio-graphical early signs of alveolar bone loss during three months. Sixty patients, 20 in each group, were studied. In the group I, overhang was removed with ultrasonic scale or bur and oral hygiene methods as usual were continued. In the group II, over-hang was left, but plaque controls as the prophylaxis and flossing were done. In the group III, restoration was changed and oral hygiene was done as usual. Plaque index and bleeding index were measured at the beginning of study and three months later. Findings: Statistical analysis of studied indices at the beginning and three months after treatment using paired test has shown significant
differences in gingival inflammation, in all groups. Statistical analysis of indices using Tukey HSD test has also shown significant differences in decreasing gingival inflammation measure when the over hanged restoration was removed. While there is no difference between the other two groups. Conclusion: The results showed that plaque control causes subsidence of gingival inflammation and increasing of alveolar bone support, and it is more effective when the over hanged restoration is changed.