Bring back the gold!

There is something about gold that just generates warm feelings inside of every dentist. Maybe it is the warm, yellow color or perhaps we have learned that gold restorations last longer in patients' mouths than any other dental material we have ever used.

Louis Malcmacher, DDS

There is something about gold that just generates warm feelings inside of every dentist. Maybe it is the warm, yellow color or perhaps we have learned that gold restorations last longer in patients' mouths than any other dental material we have ever used. We were taught in dental school that gold as a dental material restorative was king, and that is still true. Even today, you see patients on a regular basis whose mouths are in excellent condition, even though their gold restorations were done 10, 20, or even 30 years ago. Dental gold has withstood the test of time as an outstanding restoration, and probably will be the best restorative material ever available.

Even today, many dentists ask for gold when they have their own mouths restored. Most patients, however, are more interested in the aesthetic qualities of the dental restorative than its longevity. Patients frequently ask me what dental materials will last the longest, and when I say gold, they quickly lose interest due to its lack of aesthetics. Gold has even fallen out of favor in porcelain-fused-to-metal restorations, primarily because of the expense involved from the laboratory.

However, something is now available to every dentist that can bring back the gold to your dental practice, at least in terms of the high-noble metal cores for your porcelain-fused-to-metal crowns. Captek is a revolutionary material and an excellent choice for the metal under any porcelain-fused-to-metal restoration. The advantages are many:

1) You can use these materials for single- and multi-unit crown and bridge restorations.

2) They give you the warm colors and values of gold tones underneath the porcelain, which makes just about any porcelain look better. The reason your porcelain will look more lifelike with a gold core is because less opaquer typically has to be used.

3) They eliminate the gray and metal lines around the gingival margin of the crown.

Over the years, we have seen many instances where patients have a porcelain to semi- or non-precious metal crown. Upon placement, the gingiva turns dark and stays dark for the rest of the crown's life. That won't happen with a gold crown. The gingival will keep its natural color and will look and feel more natural to the patient.

The gold Captek material is also much kinder to the gingival tissue because it actually has an antibacterial effect. Clinical studies have shown that plaque and biofilm have a tougher time adhering to the surface of a Captek crown. This results in a healthier gingival situation. Remember, it's not just the aesthetics of the crown you are putting in that affects how the patient's smile looks; it also involves the health and nice pink color of the gingiva surrounding the teeth. To bring this point home even further, how many times have you gone to check patients at a recall appointment, only to find their gingival health in good order except for the gingival around the porcelain-to-metal crowns that you have done? These patients will ask you why the gums look like that only around the crowns you put in. Now we can do something about it!

One of the best reasons to use gold for all of your conventional crown and bridge treatment is that it is as cost-effective as almost any other dental material you are going to be using. The laboratory costs for a gold crown are comparable to the costs of just about any other type of crown material available. A gold crown is cemented just like any other metal-backed crown using any of the popular cements on the market. In addition, gold works with any preparation design you currently use, whether it is a chamfer, beveled, beveled chamfer, knife-edge, or shoulder-crown preparation.

Gold is still king in the dental materials field. Now you can bring back the gold standard to your porcelain- fused-to-metal crown and bridge. From a practice-management standpoint, you can assure your patients that they are receiving the beauty and warmth of gold while maintaining very healthy gingival tissues, all at a reasonable cost. This is a win-win situation for you and your patients.

Dr. Louis Malcmacher is an international lecturer and author known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via e-mail at dryowza@iname.com.

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