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Oral Health Topics

Dental Materials

Comparison of Indirect Restorative Dental Materials

FACTORS

ALL-PORCELAIN (ceramic)

PORCELAIN Fused to metal

GOLD ALLOYS (high noble)

BASE METAL ALLOYS (non-noble)

General Description

Porcelain, ceramic or glass-like fillings and crowns.

Porcelain is fused to an underlying metal structure to provide strength to a filling, crown or bridge. Alloy of gold, copper and other metals resulting in a strong, effective filling, crown or bridge.

Alloys of non-noble metals with silver appearance resulting in high strength crowns and bridges.

Principal Uses

Inlays, onlays, crowns and aesthetic veneers.

Crowns and fixed bridges.

Inlays, onlays, crowns and fixed bridges.

Crowns, fixed bridges and partial dentures.

Leakage and Recurrent Decay

Sealing ability depends on materials, underlying tooth structure and procedure used for placement.

The commonly used methods used for placement provide a good seal against leakage. The incidence of recurrent decay is similar to other restorative procedures.

Durability

Brittle material, may fracture under heavy biting loads. Strength depends greatly on quality of bond to underlying tooth structure.

Very strong and durable.

High corrosion resistance prevents tarnishing; high strength and toughness resist fracture and wear.

Cavity Preparation Considerations

Because strength depends on adequate porcelain thickness, it requires more aggressive tooth reduction during preparation.

Including both porcelain and metal creates a stronger restoration than porcelain alone; moderately aggressive tooth reduction is required.

The relative high strength of metals in thin sections requires the least amount of healthy tooth structure removal.

Clinical Considerations

These are multiple step procedures requiring highly accurate clinical and laboratory processing. Most restorations require multiple appointments and laboratory fabrication. Moderate resistance to fracture in high-load restorations. Low resistance to fracture. Low to moderate resistance to fracture.

Resistance to Wear

Highly resistant to wear, but porcelain can rapidly wear opposing teeth if its surface becomes rough.

Highly resistant to wear, but porcelain can rapidly wear opposing teeth if its surface becomes rough.

Resistant to wear and gentle to opposing teeth.

Resistant to wear and gentle to opposing teeth.

Resistance to Fracture

Prone to fracture when placed under tension or on impact.

Porcelain is prone to impact fracture; the metal has high strength.

Highly resistant to fracture.

Biocompatibility

Well tolerated.

Well tolerated, but some patients may show allergenic sensitivity to base metals.

Well tolerated.

Well tolerated, but some patients may show allergenic sensitivity to base metals.

Post-Placement Sensitivity

Sensitivity, if present, is usually not material specific.

Low thermal conductivity reduces the likelihood of discomfort from hot and cold.

High thermal conductivity may result in early post-placement discomfort from hot and cold.

Esthetics

Color and translucency mimic natural tooth appearance.

Porcelain can mimic natural tooth appearance, but metal limits translucency.

Metal colors do not mimic natural teeth.

Relative Cost to Patient

Higher; requires at least two office visits and laboratory services.

Higher; requires at least two office visits and laboratory services.

Higher; requires at least two office visits and laboratory services.

Average Number of Visits To Complete

Minimum of two; matching esthetics of teeth may require more visits.

Minimum of two; matching esthetics of teeth may require more visits.

Minimum of two

NOTE: The information in this chart is provided to help dentists discuss the attributes of commonly used dental restorative materials with their patients. The chart is a simple overview of the subject based on the current dental literature. It is not intended to be comprehensive. The attributes of a particular restorative material will vary from case to case depending on a number of factors.