Use of Gold in Crown and Bridge Procedures: The Most Versatile Restorative Material in Dentistry: A Review and Commentary

Abstract

Use of gold restorations has been almost forgotten in dentistry. They are no longer a part of most dental training curricula or often employed in private practice. Gold restorations are usually overlooked on most patient treatment plans in modern dentistry largely due to the following misconceptions: Gold is too expensive for use as a dental material. Nonetheless, the price of an ounce of gold in recent months has been at low ebb in the fluctuating precious metals market. Depending on the treatment to be performed, gold crown and bridge procedures usually use only a small part of an ounce for each particular patient case. One ounce of 18 carat dental gold makes many single-unit crowns or a few long span bridges. Pure 24 or 18 carat gold is rarely used. In practice, the gold is usually alloyed with silver, palladium, and other cheaper metals that still maintain most of the desired qualities of pure gold. Modern private practice and most dental laboratories usually prefer cheaper non-precious or semi-precious metals for porcelain-fused-to-metal (PFM) restorations or use no metal at all in other crown and bridge procedures (i.e., full porcelain and Zirconia restorations). In addition, gold restorations can be very thin whereas porcelain and Zirconia must be comparatively quite thick for strength and desired cosmetic properties. Gold is suitable only for non-cosmetic applications in dentistry. On an individual basis, suitability is dependent upon socio-cultural factors that can employ gold for cosmetic and decorative purposes with crown and bridge restorations. Gold restorations are out of fashion. On the contrary, they are an integral part of the future of dentistry and oral medicine. Although not part of the clinical training in most dental schools or general practice intern/residency programs today in dental education, gold restorations may be key restorative treatments in patients with TMJ/TMD. Porcelain and Zirconia are very hard substances and when used for dental restorations tend to wear the opposing teeth in the dentition. On the other hand, gold and most alloyed gold are softer than enamel, somewhat flexible, and therefore have a lesser propensity to wear the opposing teeth. This has implications for change of the patient’s occlusion and subsequent possible effects on the initiation and exacerbation of TMJ/TMD morbidity.

Keywords: Gold restorations, porcelain, PFM, Zirconia, TMJ/TMD, occlusion

Cite this Article

Flaer P, Badri S, Dominguez I et al. Use of Gold in Crown & Bridge Procedures: The Most Versatile Restorative Material in Dentistry: A Review & Commentary. Research and Reviews: Journal of Dentistry. 2016; 7(1): 36–40p.