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Conservative indirect restorations for posterior teeth. Cast versus bonded ceramic.
Dent Clin North Am. 1993 Jul; 37(3):433-43.DC

Abstract

The practitioner today has a number of alternative restorative modalities from which to chose when faced with the necessity of restoring posterior teeth. The primary options with extensively broken down posterior teeth are cast gold and bonded ceramic inlays, onlays, and partial veneer restorations. The dentist and informed patient should make the choice of which modality is appropriate based on a number of criteria. Certainly, based on the criteria of basic physical properties, potential for marginal integrity and stability of that integrity, cast gold is the material of choice. In terms of conservation of tooth structure and systemic biocompatibility, both restoration types are excellent. With regard to effects on long-term pulpal health, much remains unknown with many of the materials used with bonded restorations at the present time. Conservative cast gold restorations have proved to be very successful in this regard over the long term. The potential for tooth strengthening with bonded restorations is certainly an exciting, but as yet, unproven, clinical reality. Thus, until those clinical data are available, the most predictable means of restoration of extensively broken down posterior teeth is with partial-coverage cast gold, protecting cusps at risk as required (Fig. 9). As mentioned previously, cast gold inlays are also a very conservative and predictable restoration (Fig. 10). Both cast gold and bonded ceramic restorations are technically demanding, but the details required to produce excellent gold castings are well defined, and can be learned readily. Much remains to be learned regarding the materials and the techniques used to fabricate bonded ceramic restorations. Priority issues would seem to be reaching a consensus regarding the details of tooth preparation and the development of improved luting resins with improved wear resistance. Simplified techniques to improve the quality of the fit of these types of restoration also are of paramount importance. The requirement for an esthetic, or, more properly, use of a tooth-colored restoration in a posterior tooth, should be evaluated carefully for each individual restoration. Often it is possible to restore a tooth with cast gold with minimal or no display of metal. The patient will then receive the long-term benefit of cast gold and not compromise on esthetics. It is our obligation as diagnosticians to educate our patients so that they are in a position to choose, when indicated, this most cost effective of restorative options.

Authors+Show Affiliations

Department of Biomaterials Science, School of Dentistry, University of Southern California, Los Angeles.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8348996

Citation

Donovan, T E., and W W. Chee. "Conservative Indirect Restorations for Posterior Teeth. Cast Versus Bonded Ceramic." Dental Clinics of North America, vol. 37, no. 3, 1993, pp. 433-43.
Donovan TE, Chee WW. Conservative indirect restorations for posterior teeth. Cast versus bonded ceramic. Dent Clin North Am. 1993;37(3):433-43.
Donovan, T. E., & Chee, W. W. (1993). Conservative indirect restorations for posterior teeth. Cast versus bonded ceramic. Dental Clinics of North America, 37(3), 433-43.
Donovan TE, Chee WW. Conservative Indirect Restorations for Posterior Teeth. Cast Versus Bonded Ceramic. Dent Clin North Am. 1993;37(3):433-43. PubMed PMID: 8348996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conservative indirect restorations for posterior teeth. Cast versus bonded ceramic. AU - Donovan,T E, AU - Chee,W W, PY - 1993/7/1/pubmed PY - 1993/7/1/medline PY - 1993/7/1/entrez SP - 433 EP - 43 JF - Dental clinics of North America JO - Dent Clin North Am VL - 37 IS - 3 N2 - The practitioner today has a number of alternative restorative modalities from which to chose when faced with the necessity of restoring posterior teeth. The primary options with extensively broken down posterior teeth are cast gold and bonded ceramic inlays, onlays, and partial veneer restorations. The dentist and informed patient should make the choice of which modality is appropriate based on a number of criteria. Certainly, based on the criteria of basic physical properties, potential for marginal integrity and stability of that integrity, cast gold is the material of choice. In terms of conservation of tooth structure and systemic biocompatibility, both restoration types are excellent. With regard to effects on long-term pulpal health, much remains unknown with many of the materials used with bonded restorations at the present time. Conservative cast gold restorations have proved to be very successful in this regard over the long term. The potential for tooth strengthening with bonded restorations is certainly an exciting, but as yet, unproven, clinical reality. Thus, until those clinical data are available, the most predictable means of restoration of extensively broken down posterior teeth is with partial-coverage cast gold, protecting cusps at risk as required (Fig. 9). As mentioned previously, cast gold inlays are also a very conservative and predictable restoration (Fig. 10). Both cast gold and bonded ceramic restorations are technically demanding, but the details required to produce excellent gold castings are well defined, and can be learned readily. Much remains to be learned regarding the materials and the techniques used to fabricate bonded ceramic restorations. Priority issues would seem to be reaching a consensus regarding the details of tooth preparation and the development of improved luting resins with improved wear resistance. Simplified techniques to improve the quality of the fit of these types of restoration also are of paramount importance. The requirement for an esthetic, or, more properly, use of a tooth-colored restoration in a posterior tooth, should be evaluated carefully for each individual restoration. Often it is possible to restore a tooth with cast gold with minimal or no display of metal. The patient will then receive the long-term benefit of cast gold and not compromise on esthetics. It is our obligation as diagnosticians to educate our patients so that they are in a position to choose, when indicated, this most cost effective of restorative options. SN - 0011-8532 UR - https://www.unboundmedicine.com/medline/citation/8348996/Conservative_indirect_restorations_for_posterior_teeth__Cast_versus_bonded_ceramic_ DB - PRIME DP - Unbound Medicine ER -