Comparisons of InDirect Restorative Dental Materials
| Types of Indirect Restorative Dental Materials | ||||
|---|---|---|---|---|
| comparative factors | porcelain (ceramic) | porcelain (fused-to-metal) | gold alloys (Noble) | nickel OR COBALT-chrome (BASE-METAL) ALLOYS |
| General Description | Glass-like material formed into fillings and crowns using models of the prepared teeth. | Glass-like material that is "enameled" onto metal shells. Used for crowns and fixed-bridges. | Mixtures of gold, copper and other metals used mainly for crowns and fixed bridges. | Mixtures of nickel, chromium. |
| principal Uses | Inlays, veneers, crowns and fixed-bridges. | Crowns and fixed-bridges. | Cast crowns and fixed bridges; some partial denture frameworks. | Crowns and fixed bridges; most partial denture frameworks. |
| Resistance to Further Decay | Good, if the restoration fits well. | Good, if the restoration fits well. | Good if the restoration fits well. | Good if the restoration fits well. |
| Estimated Durability (permanent teeth) | Moderate; Brittle material that may fracture under high biting forces. Not recommended for posterior (molar) teeth. | Very good. Less susceptible to fracture due to the metal substructure. | Excellent. Does not fracture under stress; does not corrode in the mouth. | Excellent. Does not fracture under stress; does not corrode in the mouth. |
| Relative Amount of Tooth Preserved | Good - Moderate. Little removal of natural tooth is necessary for veneers; more for crowns since strength is related to its bulk. | Moderate-High. More tooth must be removed to permit the metal to accompany the porcelain. | Good. A strong material that requires removal of a thin outside layer of the tooth. | Good. A strong material that requires removal of a thin outside layer of the tooth. |
| Resistance to Surface Wear | Resistant to surface wear; but abrasive to opposing teeth. | Resistant to surface wear; permits either metal or porcelain on the biting surface of crowns and bridges. | Similar hardness to natural enamel; does not abrade opposing teeth. | Harder than natural enamel but minimally abrasive to opposing natural teeth. does not fracture in bulk. |
| Resistance to Fracture | Poor resistance to fracture. | Porcelain may fracture. | Does not fracture in bulk. | Does not fracture in bulk. |
| Resistance to Leakage | Very good. Can be fabricated for very accurate fit of the margins of the crowns. | Good ; Very good depending upon design of the margins of the crowns. | Very good ; Excellent. Can be formed with great precision and can be tightly adapted to the tooth. | Good-Very good ; Stiffer than gold; less adaptable, but can be formed with great precision. |
| Resistance to Occlusal Stress | Moderate; brittle material susceptible to fracture under biting forces. | Very good. Metal substructure gives high resistance to fracture. | Excellent | Excellent |
| Toxicity | Excellent. No known adverse effects. | Very Good to Excellent. Occasional/rare allergy to metal alloys used. | Excellent; Rare allergy to some alloys. | Good; Nickel allergies are common among women, although rarely manifested in dental restorations. |
| Allergic or Adverse Reactions | None | Rare. Occasional allergy to metal substructures. | Rare; occasional allergic reactions seen in susceptible individuals. | Occasional; infrequent reactions to nickel. |
| Susceptibility to Post-Operative Sensitivity | Not material dependent; does not conduct heat and cold well. | Not material dependent; dies not conduct heat and cold well. | Conducts heat and cold; may irritate sensitive teeth. | Conducts heat and cold; may irritate sensitive teeth. |
| Esthetics (Appearance) | Excellent | Good to Excellent | Poor; yellow metal | Poor; dark silver metal |
| Frequency of Repair or Replacement | Varies; depends upon biting forces; fractures of molar teeth are more likely than anterior teeth; porcelain fracture may often be repaired with composite resin. | Infrequent; porcelain fracture can often be repaired with composite resin. | Infrequent; replacement is usually due to recurrent decay around margins | Infrequent; replacement is usually due to recurrent decay around margins. |
| Relative Costs to Patient | High; requires at least two office visits and laboratory services. | High; requires at least two office visits and laboratory services. | High; requires at least two office visits and laboratory services. | High; requires at least two office visits and laboratory services. |
| Number of Visits Required | Two -minimum; matching esthetics of teeth may require more visits. | Two - minimum; matching esthetics of teeth may require more visits. | Two - minimum | Two - minimum |
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