This review is a systematic assessment, from the literature, of the status quo of dental amalgam, resin-based composite and glass-ionomer restorations for carious lesions as it applies to new concepts, coupled with clinical research. Scientifically based and practical new materials and techniques are recommended to include in contemporary practice throughout the world. Clinical and laboratory studies which have been carried out in light of modern conservative principles, and in light of the current emphasis of treating dental caries as a disease process were reviewed and discussed. An approach to managing carious lesions based upon selected advantages of dental amalgam, resin-based composite and glass-ionomer technology applied to what is termed "preservation-based" approaches to restoring teeth has been synthesized. Researched evidence contradicts the notion of "extension for prevention" in favor of maintaining sound tooth structure which would translate into more patients with healthy dentitions for entire lifetimes.