Clinical
restoratio s S
Cast gold
In the second article in our series from members of the British Academy of Restorative Dentistry, Stuart Campbell and Paul Tipton explore an often-neglected material
CPD
To qualify for one hour’s verifiable CPD, read this article and then log on to www. scottishden-
talmag.co.uk to answer the multiple choice questions and print out your certificate. The aim of this article is to review the application of cast gold for the restoration of damaged posterior teeth. By reading the article and answering the online questions, the reader should understand the advantages of cast gold restora- tions, the factors important to case planning and the principles of preparation.
42 Scottish Dental magazine
ince Taggart described the lost wax technique for producing cast restorations in
ı907, gold-based alloys have been used for the restoration of posterior teethı. However, in recent years,
many dentists have excluded cast gold restorations from their practice on the grounds that they suffer from poor aesthetics, incur high costs and demand exacting preparations. Christensen in 200ı2
reported that gold castings accounted for only eight per cent of laboratory-produced restorations. This is supported by Federlin et al3, who noted a general trend toward ceramic restorations being the preferred choice of patients and clinicians for the restora- tion of posterior teeth. Faced with such data, it
could be suggested that cast gold restorations have little value in contemporary dental practice. However, it should be realised that many of the modern alternatives to gold alloy are supported by weak, often biased, research and fail to offer many of the advantages of cast gold such as2,4,5: • high fracture resistance
• superior marginal integrity, even after years of function • coefficient of thermal expan- sion similar to tooth structure • corrosion resistance • does not require adhesive bonding • biocompatible • does not discolour tooth structure • does not wear or abrade the opposing dentition • minimal removal of tooth structure is required to support occlusal function. One further advantage is
longevity6-8. Donovan et al6 reported on the long-term success of ı,3ı4 cast gold resto- rations placed in ıı4 patients over a 52-year period. Results from this study showed that 96 per cent of the gold restora- tions evaluated were described as being excellent in terms of
marginal integrity, anatomical form and surface texture. In summary, therefore, it
may be stated that: • properly fabricated cast gold restorations can provide extremely predictable long term service • cast gold should be consid- ered for patients who are more concerned with longevity than aesthetics. This may explain the find-
ings of both Christensen in ı9869 and Rosensteil et al in 2004ı0 who suggest that most dentists prefer the use of gold alloy for the restoration of their own posterior teeth. This article may be helpful
to clinicians who believe that cast gold restorations may have a part to play in their practice and will consider their successful use under
“In recent years, many dentists have excluded cast gold restorations from their practice on the grounds that they suffer from poor aesthetics”
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