Clinical REFERENCES: Fig 11 Fig 12 Figures 11 and 12: Rubber Dam removed and final finishing carried out Continued »
speed moving from gold to tooth in three planes. Finally, the restoration is polished by applying a mixture of pumice and aluminium oxide powder using a rubber prophy cup (Figures ıı and ı2).
Conclusion Cast gold restorations produced with type II or III gold alloys are among the longest-lasting dental mate- rials and have a proven clinical track record5,6,ı0,ı2. They have a wide application and are useful when space is reduced due to shallow anterior guidance or when wear of the opposing teeth is a concern5,ıı. The preparation techniques
are easily learned with practice and are less invasive than those required for all-ceramic and ceramo-metal restorationsı4. Advances in dentine bonding agents have led to the devel- opment of adhesively retained cast gold restorations, perhaps the ultimate conserv-
ABOUT THE AUTHORS
Stuart Campbell is the principal of Loanhead Dental Practice in Midlothian and chairman of the Edinburgh branch of BARD. His clinical interests are in prostho- dontics and implantology. He spent three years training with Dr Paul Tipton in Manchester as well as completing several year-long restorative courses in Europe and the UK. He is the author of several published clinical articles and is currently undertaking an MSc in implant dentistry.
Dr Paul Tipton is an internation- ally acclaimed prosthodontist who
46 Scottish Dental magazine
of Tipton Training Ltd, one of the UK’s leading private dental training academies, and the author of over one 100 scientific articles for the dental press. He was voted in the Top 10 ‘most influential dentists in the UK’ by his peers in Dentistry Magazine in April 2011, and was voted in the top five dentists in Private
has worked in private practice for more than 30 years. He is the founder
Stuart Campbell
Dentistry’s Elite 20 poll, January 2012. He is a lecturer on the MSc programme
ABOUT THE BARD
The British Academy of Restorative Dentistry (BARD) was set up in 2009 and aims to improve the quality of restorative dentistry by promoting educational opportunities. BARD is the only organisation of its kind to offer a complete training pathway from membership through certification, diploma and on to fellowship. All dental professionals can join the academy and our members benefit from annual scientific meetings and local study clubs, both offering an opportunity to learn from national experts and to network and socialise with like-minded dental professionals. For more information on the BARD and how to join the academy, please visit
www.bard.org.uk
ative indirect posterior restorationı5,ı6. Despite these advantages,
the popularity of cast gold has faded in recent years and this may be attributed to the growth in tooth-coloured alterna- tives. It should be appreciated however, that many of these restorations are backed by manufacturer’s claims and have a weak evidence base. All patients requiring indi-
rect restorations for their teeth should be informed of the treatment possibilities so that valid consent can be provided. The benefits of longevity and less invasive tooth reduction may be preferred by some patients to the tech-
nique required for more aesthetic alternatives.
® Acknowledgments: All laboratory work provided by Kenneth Scott RDT, A-Plus Dental Laboratory, Dundee, Scotland.
Further information: The preparation techniques for cast gold preparations are taught at the following locations: Tipton Training Phantom Head Course
www.tiptontraining.co.uk British Academy of Restorative Dentistry Edinburgh Study Club
www.bard.uk.com RV Tucker Cast Gold Study Club
www.arvtsc.org/
Paul Tipton
in Aesthetic and Restorative Dentistry at Manchester and also at King’s College London (LonDEC). Paul is currently the president of the British Academy of Restorative Dentistry and practises at his clinics in Manchester, Leeds, Chester and London. All details can be found at
www.drpaultipton.co.uk
1. Taggart WH. A new and accurate method of making gold inlays. Dent Cosmos 1907;49:1117-1121 2. Christensen GJ. Cast gold restorations. Has the aesthetic dentistry pendulum swung too far? J Am Dent Assoc. 2001 Jun;132(6):809-11. 3. Federlin M, Wagner J, Männer T, Hiller KA, Schmalz
G.Three-year clinical perfor- mance of cast gold vs ceramic partial crowns. Clin Oral Investig. 2007 Dec; 11(4):345- 52. Epub 2007 Nov 1. 4. Small BW. Intracoronal cast gold restorations. Gen Dent. 2010 Mar-Apr;58(2):91-3. 5. Tucker RV. Why gold cast- ings are excellent restorations. Oper Dent. 2008 Mar-Apr; 33(2):113-5. 6. Donovan T, Simonsen RJ, Guertin G, Tucker RV. Retro- spective clinical evaluation of 1,314 cast gold restorations in service from 1 to 52 years. J Esthet Restor Dent. 2004; 16(3):194-204. 7. Bentley C, Drake C W. Longevity of restorations in a dental school clinic. J Dent Educ 1986; 50: 594–600 8. Mjor I A, Medina J E. Reasons for placement, replacement, and age of gold restorations in selected practices. Oper Dent 1993; 18: 82–87 9. Christensen GJ. The use of porcelain-fused-to-metal restorations in current dental practice: a survey. J Prosthet Dent. 1986 Jul; 56(1):1-3. 10. Rosenstiel SF, Land MF, Rashid RG. Dentists’ molar restoration choices and longevity: a web-based survey. J Prosthet Dent. 2004 Apr; 91(4):363-7. 11. Wise MD. Failure in the Restored Dentition: Manage- ment and Treatment. London: Quintessence, 1995.p.303-304 12. Downer MC, Azli NA, Bedi R, Moles DR, Setchell DJ. How long do routine dental restora- tions last? A systematic review. Br Dent J. 1999 Oct 23; 187(8):432-9. 13. Smith BGN. Planning and Making Crowns and Bridges. 3rd ed. London: Martin Dunitz, 1998. p.34, 14. Tipton PA. Cast Gold Resto- rations: Phantom Head Course Preparation Guide. Tipton Training 2009. 15. O’Brien WJ. Dental Materials and Their Selection. Chicago: Quintessence, 2008. p.346-350 16. Chana H, Kelleher M, Briggs P, Hooper R. Clinical evaluation of resin-bonded gold alloy veneers. J Prosthet Dent. 2000 Mar; 83(3):294-300. 17. Briggs P, Chana H, Kelleher M, Poyser N. The clinical application of posterior resin- bonded cast metal restora- tions. Dent Update. 2002 Sep; 29(7):331-7.
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