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Comparison of Indirect Restorative Dental Materials |
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FACTORS |
ALL-PORCELAIN (ceramic) |
PORCELAIN Fused to metal |
GOLD ALLOYS (high noble) |
BASE METAL ALLOYS (non-noble |
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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. |
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Principal Uses |
Inlays, onlays, crowns and aesthetic veneers. |
Crowns and fixed bridges. |
Inlays, onlays, crowns and fixed bridges. |
Crowns, fixed bridges and partial dentures. |
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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. |
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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. |
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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. |
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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. |
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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. |
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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. |
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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. |
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Post-Placement Sensitivity |
Sensitivity, if present, is usually not material specific. |
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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. |
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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. |
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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. |
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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 |
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