Making aesthetic gold restorations

If gold is so great, why not restore every cavity with gold? A good clinician knows how to choose the right restorative material for each situation- and not every filling calls for gold. Let’s discuss some disadvantages to gold. This article is adapted from Dr. Tucker’s article in Operative Dentistry, March 2008.

1. Gold is not tooth-colored.
Did you know that gold has historically been a favorite restorative material? It was precisely for its beautiful warm sparkle. In fact, F.H. Veo who graduated from Harvard Dental School in 1897 embellished this denture with gold.

denture

Gold restorations are rarely recommended for restoring the front teeth. In addition, a trained expert can prepare the tooth to make the gold less visible.

occlusal view of restoration #12 and #13

occlusal view of restoration #12 and #13

from the front, both #12 and #13 are tucked away and hidden from view

from the front, both #12 and #13 are tucked away and hidden from view

 

2. Gold is more expensive.
Gold restorations take more appointments. The operator has to prepare the tooth and create a shape with specific dimensions without undercuts. One study by Bentley and Drake studying the longevity of 1,207 restorations found that after ten years, 91.1% of gold restorations had survived compared to 72% for amalgam and 55.9 composite. Since gold inlays and onlays last longer than alternative restorations, the patient receiving gold saves more money in the long run.

3. Gold restorations are more technique-sensitive.
As we discussed in the previous article, it is important to go to someone who has been specifically trained in gold restorations. There are study clubs and organizations devoted to gold castings.

Yesle Kim, Group 58, Penn ’16 DMD

Sources

1. “Why Gold Castings are Excellent Restorations” by RV Tucker, Operative Dentistry, March 2008
2. Collections of the Harvard Dental School Museum
3. “Longevity of restorations in a dental school clinic” by Bently and Drake, Journal of Dental Education, 1986

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