Indirect restorations

Cast gold restorations

Dr. Mohamed Shabayek
Lecturer, Operative Dentistry Department MSA University

Indirect restoration
Any restoration that is fabricated outside the oral cavity then finally inserted and cemented into the tooth.

Outline form
1. 2. 3. 4. 5. 6. Diverdence of the walls. Internal line angles. Cavity depth. Secondary flare. Isthmus portion. Cavosurface angle

Outline form
1. Internal cavity walls must be uniformly divergent.

3-5 for each wall

Why should the walls be divergent?

In order to seat the inlay.

2. All internal line angles must be well defined but not sharp.

3. Cavity depth
High mechanical properties

No need for bulk.

No need for bulk preparation

Shallower than amalgam

Just break DEJ. Total cavity depth 1.5-2 mm.

4. Secondary flare for proximal cavity preparations

Secondary flare
Extends the margins into the embrasures i.e self cleansable area. Allows gradual thinning of the metal which allows for burnishing without weakening of the metal. Stronger and thicker enamel will result

5. Isthmus portion
It is the junction between the occlusal portion and the proximal portion. Its width depends on the caries extension and the mechanical properties of the restorative material.

1 5

1 4

inter cuspal distance.

6. Cavo-surface margin should be beveled

To allow burnishing of the casting which bring the margin of the alloy in max proximity to the enamel margin and protect cement line.

Amalgam

Cast gold

CSA =90

CSA= 120-140

Axio-pulpal line angle should be beveled.

Outline
Taper of the walls Internal line angles

Amalgam Cast gold Converge occlusally Diverge occlusally Definite but not sharp 1 mm below DEJ Absent
1 4

Cavity depth Secondary flare Isthmus portion Cavosurface angle

Just break DEJ present

1 5

1 3

ICD

1 4

ICD

90

120-140

Axial retention

Retention

i. Length of the wall.

ii. Degree of divergence.

iii. Surface roughness.

iv. Grooves
v. Cement type.

Length of cavity wall

The longer the wall, the greater the friction between opposing walls, the higher the retention.

Degree of divergence
Increase the divergence more than 10 decreases the retention.

Surface roughness
Roughness on the surface increases the retention

Grooves
Axial grooves increase surface area which increases the friction between opposing walls. Length of grooves. Number. Taper.

Retention
Lateral retention
i. Dove tails.

Lateral retention
ii. Proximal grooves.

Lateral retention
iii. Reverse bevel (in the gingival seats)

Resistance
Weakened cusps should be capped
Counter bevel

Impression
Most accurate impression material (Single phase) Opposing arch. Bite registration.

Laboratory fabrication

Try in stage and burnishing

Occlusion adjustment and polishing

Cementation
Dental cements
Zn Phosphate Conventional
Zn Polycarboxylate

Glass ionomer (Modifications)

Resin based

Final restoration