Opening the conversation: What is the best restorative material still in existence and use?
This question was submitted by a general dentist and is a conversation opener on the best restorative materials based on your experience.
Related questions include:
- Is cast gold a long lost art?
- How many of us are still able to offer it to our patients?
- What would we as dentists put in our own mouths ?
Dr. John Miner provided the following response:
- Yes…fabricating well-fitting/occluding Gold Restorations is a lost art;
- I offer Gold Restorations to my patients;
- I would definitely advocate the use of Gold Restorations in my mouth.
Let us know what you think. You can reply to this post below or send us your response via email at oasisdiscussions@cda-adc.ca, or call us toll free at 1-855-716-2747
I have two gold crowns, and one gold onlay in my mouth, by choice. I had to tell my dentist how to do an onlay prep.
i think amaglam .
In the appropriate clinical situation, emax lithium disilicate.
On second molars where function is more important than aesthetics, we do quite a number of full gold crowns. Since it is done with full disclosure and patients are encouraged to ask questions, we do not have any negative feed back.
Would I have FGCs in my own mouth? Yes, I would. I do not have a broad smile at all but brux to a point, I would destroy the ceramic alternatives.
FGCs are a very reliable service and having watched ‘porcelain flavours of the month’ come and go, I would not be in a hurry to abandon this alternative. We simply have more choices and these can be made prudently. FWIW.
I still think gold is the best, it has the most close to enamel thermal expansion AND CONTRACTION. eNAMEL IS AROUND 9 to 12 and the gold is around 12 to 15. Amalgam is aroud 22 to 30, but has a self sealing ability and some ability to destroy bacteria. Composites are around 65 to 180.. The average for composite retention is 5 to 7 years, and amalgam 10 to 14 years. Gold I have some in my own mouth that are 55 years old and still going strong.. There isa lot of pressure from patients to do WHITE fillings, and this is OK as long as they are told the hicups that can occur. DON
Before entering into this vast discussion and risk going in endless circles, we should acknowledge the superiority of what mother nature put there in the first place, our role in prevention and the limitations inherent in everything we do. Then we’ll talk about what seems to work in our hands.
Now, on to the conversation.
When I did my first few 3/4 gold crowns and onlays, I knew I had something that worked for me: conservation of tooth structure, especially buccal enamel and full occlusal coverage. Ideal for restoring endodontically treated molars and bicuspids in many patients.
I was a patient at a Tucker Gold Study Club and had some inlays placed but my dentist took them out 5 or 6 year later due to recurrent decay. I wonder if perhaps the cement failed to seal the entire gingival margin. Now, whenever I cement any crown or onlay I direct the assistant to make sure all internal surfaces are covered by cement. When seating a 3/4 crown, cement is lost out along the occlusal buccal margin leaving less for the gingival margins.
Retention of onlays, 3/4 or 7/8 crowns can be an issue when they serve as the posterior bridge abutments. On tipped molars, the retention grooves must be accurately placed. I have sometimes taken a mid-preparation impression and poured it up, just to verify the accuracy of my retention grooves.
Gold is still an outstanding material for many patients in many situations, but direct restorative dentistry is my bread and butter.