Direct filling gold in dentistry /cosmetic dentistry courses

“DIRECT
FILLING
”
INDIAN DENTAL ACADEMY
Leader in continuing Dental
Educationwww.indiandentalacademy.com

“INGREDIENTS”
Introduction
History
Classification
Physical properties
Indications
Contraindications
Types of gold used in dentistry
Annealing and degassing
Condensation and compaction
Compaction technique
Biocompatibility of gold
Uses of liners and bases
Cavity preparations and designs
Advantages and disadvantages
References
Conclusion www.indiandentalacademy.com

“HISTORY OF GOLD”
First evidence of use
of gold filling – 3000
BC.
Govann D Arcoli
recommended gold leaf
fillings in 1843.
Gold foil restorations
were introduced by
Robert Woffendale in
1795.
Cohesive gold was
introduced by
American dentist
Robert Arthur in
1855.
www.indiandentalacademy.com

“Raw gold”
“Melting process of gold”

“Classification of direct filling gold”
1. Foil (Fibrous gold)
- Sheets
- Ropes
- Cylinders
- Laminated foil
- Platinized foil
- Corrugated foil
2. Electrolytic
precipitate
(crystalline gold)
- Mat gold
- Mat foil
- Gold calcium alloy
3. Powdered or
granulated gold
- Gold dent

“PHYSICAL PROPERTIES OF
GOLD”
Noble
Not affected by air, heat, moisture or solvents
Fusesat 10630C and boils at 22000C
Ductile
Malleable
Density of gold is 19.3g/cm3
BHN is 25 but cold working increases the hardness to 58-82.
Tensile stress after cold working increases from 19,000psi –32,000psi
Yield strength increases from 0-30,000psi
Coefficient of thermal expansion
High thermal conductivity of 0.71cal/sec/cm2
Solubility
Non soluble in aqua regia
Can be cold worked and welded at room temperature.
Efficient sealing restorative material.

INDICATIONS
Lesions of very limited dimensions and extent.
Lesions in which cavity margins can be located on
sound enamel surfaces.
Lesion in vital teeth, having sound pulpal dentinal
organ, intact periodontium, and ability to withstand
condensation forces.
Lesions in which tooth structure left after removal of
diseases tissues is bulky enough to create self resisting
walls and pronounced retention modes.
Patients with good oral hygiene, low caries and plaque
indices.
Lesions with adequate access for detailed preparation
and instrumentation.
Teeth with no enamel crazing or micro crackswww.indiandentalacademy.com

“SITES”
1. Incipient carious lesion
Occlusal, buccal, lingual pit and
fissure
Class II lesions on premolars and
mesial of first molar
Class III in maxillary and
mandibular teeth
Class V in bicuspids, cuspids where
esthetics permit
2. Atypical lesions
Proximal lesions on teeth adjacent
to crown preparations
Vent holes in crown and defective
inlay can be repaired.
Class VI lesions
Retrograde root canal fillingwww.indiandentalacademy.com

CONTRAINDICATIONS
Teeth with large pulp chamber
Severally periodontal weakened teeth
Large carious lesions
Handicapped elderly patients who cant give long sittings
Psychologically unsound patients who fear malleting forces
Economics
Esthetics
No isolation
Undesirable occlusal stress
High caries index
Inaccessible areas
Hypoblastic tooth
Young permanent teeth
In case of underdeveloped roots

TYPES OF GOLD

A.COHESIVE GOLD
B.SEMICOHESIVE GOLD
C.NONCOHESIVE GOLD

ANNEALING / DEGASSING

CONDENSATION / COMPACTION OF DIRECT
FILLING GOLD
OBJECTIVES :
• To weld
• To wedge
• To minimize the voids
• Adaptation of the gold to
cavity walls
PRINCIPLES :
• Line of force
• Stepping or shingling
• Use minimum thickness of pellet present for condensation
• Force of the blow

INSTRUMENTS USED FOR COMPACTION
CONDENSING AND MALLETING :
Condensers :
Round condensers
Parellogram condensers
Foot condensers
Malleting :
Hand malleting
Automatic hand malleting
Electric malleting (McShriley electromallet)
Pneumatic malleting (Hollenback condenser)www.indiandentalacademy.com

“COMPACTION TECHNIQUE”
GENERAL STEPS FOR INSERTION :
Three steps build up for the restoration
Tie formation
Banking of walls
Shoulder formation
Paving of restoration
Surface hardening of restoration
Burnishing
Margination
Burnishing
Contouring
Finishing and polishing

CAVITY PREPARATION AND DESIGN
PRINCIPLES OF CAVITY PREPARATION :
Outline form
Resistance form
Primary retention form
Convenience form
Class I
Class II
Class III
Ferrier’s design
Loma Linda design for class III
Ingraham design
Class V
Ferrier’s design

Class III design:
Ferrier’s design:
• Entry is made from the facial surface
• caries is removed by a no.1 round
bur and the outline form is made
with a pear shaped bur.
• the retentive grooves are made with
33 ½ inverted cone bur.
• Its indicated for those lesions that
extend minimally on to the facial
surface
• So its mostly used in distal surfaces
of anterior teeth.
• General outline is triangular in
shape

• Incisal margin is placed incisal to the
contact
• Convenience form is made by the
incisolingual curve. Incisal curve
connects facial and lingual margins of
the preparation.
• Axial wall is flat faciolingually and
inciso gingivally and is 0.5mm into
dentin
• Resistance form is by sharp obtuse
axiofacial and axiolingual line angles
• Facial and lingual wall diverge lightly
only to remove undermined enamel
• Retention form is provided between
incisal and gingival walls.www.indiandentalacademy.com

• Dentinal part of the gingival wall slopes apically inward to
create an acute axiogingival line angle
• Incisally, an undercut is made in the dentin, facioincisally,
to create a mechanical lock between incisal and gingival
walls. This increased retention is needed because of the
length of the preparation mesiogingivally and of difficulty
on getting access
• Placement of facial, lingual, incisal cavosurface bevel
decides the final marginal outline
• Its made with hand instruments and is totally in enamel

Loma Linda design for Class III
• This design is made with a lingual access
• So its best indicated where esthetics is the major concern
and where carious extent is such that the lingual marginal
ridge is involved.
• General shape of the cavity is triangular with rounded
corners

• Lingual wall as such is not there, only lingual margin
present.
• Loma Linda differs from ferrier’s design in that it has more
rounded margins, lingual access and bulkier retention
modes.
• The labial margin follow the labial contour of the tooth
• Gingival margin is not perpendicular to long axis of tooth.
It varies about 120 degree
• Incisally and gingivally there is a rapid turn

• Planning of incisal, lingual, facial, gingival walls are done
with GMT
• Cavosurface bevels are not given in these preparation and
the walls should terminate in butt cavosurface margins
• Three retention grooves in opposing direction are placed
with No. ½ round bur into dentin
• inciso linguo gingival point
• Facioaxio gingival point
• Incisal point

Ingraham design:
• It is for incipient proximal lesions in
anterior teeth where esthetics is the
major concern
• General shape is parallelogram
• Labial margin is in contact area, so
not visible labially
• Retention grooves are placed on the
incisoaxial and gingivo axial line
angles
• Bevel may be placed with GMT on
all margins
• Plane all walls with hatchet.www.indiandentalacademy.com

Class V cavity preparation
Ferrier’s design:
• General outline is trahezoidal in
shape
• Gingival wall and occlusal wall are
flat and parallel to occlusal plane
• Occlusal wall is longer than gingival
• Mesial and distal walls makes an
obtuse angle with the gingival wall
and an acute angel with the occlusal
wall
• Mesiodistally axial wall can be curved
so as to prevent encroachment on the
pulp
• But excessive curvature results in
preparation which is too shallow inwww.indiandentalacademy.com

• Axial wall is 1mm deep occlusally and as it comes down
cervically, its . 75mm
• Mesioaxial and distoaxial line angles are obtuse so as to
prevent any undermined enamel and also gives resistance to
movement of gold during compaction.
• They must never be acute angles
• The mesial and distal walls
provide resistance for gold
compaction, but they don’t
give retention.
• Retention is provided by
sloping of the gingival wall
internally to meet axial wall
in a sharp defined acute
angle. www.indiandentalacademy.com

• Retention so is achieved by facial convergence of occlusal
and gingival walls.
• Where gingival margin on enamel, cavosurface is beveled,
when on cementum, its not beveled
• Hoe is used for planning the restoration walls and giving
sharp internal line angles
• According to the caries extent, different designs of class V
preparation can be made.

Class V with proximal pen handle extension:
• Its called so as it looks like a pen handle
• Parallelogram in design
• Used in – proximal extension cases
Class V with uni or bilateral mustache extension:
• Its given where surface defects are present occlusal to height of
contour
Semilunar shaped cavity:
• Cases where esthetics
are important,
trapezoidal shape is
avoided and a
semilunar shape is
made.

Stop ‘F’
E-Z

ADVANTAGES :
Gold is a noble metal and so wont tarnish or corrode
Direct gold restoration insoluble and has thermal expansion
similar to that of dentin.
Gold adaptation of the material to the cavity wall
Density and hardness of compacted gold can withstand the
compressive forces of occlusion.
Condensed gold can be effectively
polished.
Pure gold is ductile, this property is
useful in producing an accurate margin
for the restoration.
It is the one of the permanent type of a
restoration www.indiandentalacademy.com

DISADVANTAGES :
Yellow color of gold is
unesthetic to many
Thermal conductivity can
be a problem
Manipulation of gold is
difficult to master. It
requires skill and practice
We can’t give opposite to
the amalgam restoration

Are liner and bases are required under
direct filling gold
?3mm or more remaining dentin – no base
2mm or more – varnish on walls and floors, without
cavosurface margins.
Between 1-2mm – subbase of Ca(OH)2 or unmodified ZOE
over this varnish. Then use ZnPO4 cement or
zincpolycarboxylate
Less than 1mm – direct filling gold contraindicated

1. Skinners textbook of dental material
2. Maggie
3. Craig O Brein
4. Studeraevant – textbook of operative
dentistry
5. Vimal Sikri
6. Scwartz – textbook of operative
dentistry

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