Gold foil restorations?

[tuyere]

Anybody have any good resources or info about the gold foil technique for fillings? I'm intrigued, but it's discussed in articles as if it's nearly extinct and it's hard to get dentists to perform it. How true is that?
...it's also not really in a dental tech's wheelhouse because it's prepared in situ, like amalgam, but the jeweller in me is compelled.

this is pretty much the only modern article on it that i've seen: https://www.dentistrytoday.com/sp-1547062389/ everything else is from the sixties or earlier.

 

[TheLabGuy]

Insurance killed it!!! Tough to even find the clinical CDT codes for it anymore I imagine, let alone getting a insurance to pay for it. Sure is pretty stuff but Docs hated it...took too long chairside to do properly. Heck, most Docs burnish amalgam with a wet cotton roll versus the way it's supposed to be done.

 

[Dentalmike]

My understanding is that technique was abandoned because of the pneumatic handpiece, essentially a mini jackhammer used to condense the gold, caused those teeth to need root canals. they were beautiful when done well.

 

[Davor RDT]

Anybody have any good resources or info about the gold foil technique for fillings? I'm intrigued, but it's discussed in articles as if it's nearly extinct and it's hard to get dentists to perform it. How true is that?
...it's also not really in a dental tech's wheelhouse because it's prepared in situ, like amalgam, but the jeweller in me is compelled.

this is pretty much the only modern article on it that i've seen: https://www.dentistrytoday.com/sp-1547062389/ everything else is from the sixties or earlier.

Tucker study club.

 

[grantoz]

yes you used to get split teeth from packing to hard etc

 

[Flipperlady]

Anybody have any good resources or info about the gold foil technique for fillings? I'm intrigued, but it's discussed in articles as if it's nearly extinct and it's hard to get dentists to perform it. How true is that?
...it's also not really in a dental tech's wheelhouse because it's prepared in situ, like amalgam, but the jeweller in me is compelled.

this is pretty much the only modern article on it that i've seen: https://www.dentistrytoday.com/sp-1547062389/ everything else is from the sixties or earlier.

I was lucky enough to work with a dentist way back that knew how to do this. He had the little pneumatic hammer and I watched him place one (actually its bits of gold sheet "hammered" in} although it was an old technique then. I pulled out Dr Rudd's Laboratory Procedures book and I think it says volume 2 page 421 for repairing with gold foil. I can only find volume 1 at moment but maybe it's online somewhere. Dental Lab Procedures volume 2 page 421

 

[zero_zero]

I have an old dentist friend down here, a fellow expat, who knows to do it, and swears by it...he's 73

 

[tuyere]

Insurance killed it!!! Tough to even find the clinical CDT codes for it anymore I imagine, let alone getting a insurance to pay for it. Sure is pretty stuff but Docs hated it...took too long chairside to do properly. Heck, most Docs burnish amalgam with a wet cotton roll versus the way it's supposed to be done.

I very much appreciated the article I linked helping out on this point:
"The code number that has been used successfully by the authors for class I and V gold foils is 02410."

 

[Tayebdental]

I have an old dentist friend down here, a fellow expat, who knows to do it, and swears by it...he's 73

Old dentist and 73?

 

[zero_zero]

Old dentist and 73?

Old compared to me...lol

 

[tuyere]

Found a pretty thorough ~60s-era book chapter on the technique, I like the diagrams showing the different working techniques for different gold preparations, and the schematics of the prepared cavities that show the undercuts you need to use to retain the gold.

 

[tuyere]

I don't want to nor plan to do any real dentistry, but I'm still hooked by this technique, it's so much like the jeweller's work I used to do when setting stones, filigreeing engravings, etc.
Suppliers still seem to carry condensers and gold foil, I'm seriously considering trying this decoratively on sintered zirconia restorations, it's pretty enough to stand on its own without having to fill in any cavities. Don't think gold foil is exactly going to fall into my lap, though.

 

[Davor RDT]

Found a pretty thorough ~60s-era book chapter on the technique, I like the diagrams showing the different working techniques for different gold preparations, and the schematics of the prepared cavities that show the undercuts you need to use to retain the gold.

Thank you for shareing.

 

[tuyere]

In turn,

Tucker study club.

thanks for bringing this to my attention, finding a local dentist who still practices this technique would be impossible otherwise.
One of the articles I read made a persuasive case regarding how 'modern' filling techniques with short lifespans tend to lead towards repeated and increasingly-severe restorations that degrade otherwise-healthy teeth prematurely, so opting for highly-stable, minimally-destructive techniques like direct gold should be preferred in younger people with decades of chewing to go. Hadn't thought about it that way, but yeah, the epoxy fillings I got in my twenties are already giving up the ghost, this cycle repeating itself once a decade obviously isn't sustainable.

 

[PCDL]

I don't want to nor plan to do any real dentistry, but I'm still hooked by this technique, it's so much like the jeweller's work I used to do when setting stones, filigreeing engravings, etc.
Suppliers still seem to carry condensers and gold foil, I'm seriously considering trying this decoratively on sintered zirconia restorations, it's pretty enough to stand on its own without having to fill in any cavities. Don't think gold foil is exactly going to fall into my lap, though.

That would be a really cool Restorative/Art project. I think you could do some crazy things (costly too...) with it. You could really go nuts carving out the recesses in the ZR pre-sintering and have some really intricate patterns. Fun!

 

[tuyere]

That would be a really cool Restorative/Art project. I think you could do some crazy things (costly too...) with it. You could really go nuts carving out the recesses in the ZR pre-sintering and have some really intricate patterns. Fun!

Yeah, that was my thinking- add a decorative design to an ordinary restoration mesh, sweep a negative-draft profile along it to create a pocket with mechanical retention, mill it, fire it, and then condense away. I think I could get an acceptable undercut with 5-axis milling and tiny little end mills. Or just freehand the design, none of it is dimensionally-critical like it is with a solid cast inlay element, and you could do a much finer design that uses less metal.

Just wish I could practice with literally anything that isn't gold, lol

 

[Flipperlady]

Yeah, that was my thinking- add a decorative design to an ordinary restoration mesh, sweep a negative-draft profile along it to create a pocket with mechanical retention, mill it, fire it, and then condense away. I think I could get an acceptable undercut with 5-axis milling and tiny little end mills. Or just freehand the design, none of it is dimensionally-critical like it is with a solid cast inlay element, and you could do a much finer design that uses less metal.

Just wish I could practice with literally anything that isn't gold, lol

Try copper foil, it's soft.

 

[tuyere]

I was under the impression that pure noble metals are the only thing that'll properly micro-weld with condensing, it's almost all gold but I found some research papers about how platinum-silver alloys can also work. anything that tarnishes and produces an oxide/passivated outer skin won't bond, it'll just be a bunch of foil mashed together, and I wouldn't think that's really representative of the dynamics of gold condensing.

 

[Flipperlady]

I was under the impression that pure noble metals are the only thing that'll properly micro-weld with condensing, it's almost all gold but I found some research papers about how platinum-silver alloys can also work. anything that tarnishes and produces an oxide/passivated outer skin won't bond, it'll just be a bunch of foil mashed together, and I wouldn't think that's really representative of the dynamics of gold condensing.

When I was training to be a jeweler, for the first three semesters we used silicon bronze instead of gold. The fourth semester we switched to gold, it was wonderful. If you have the money to practice with the real thing go for it