Porcelain Fused to Gold vs Regular PFTM Crown in Posterior
Quote:
> Generally, the quality of the crown is more dependent on the skill
> of the dentist and the technician than what the coping is made of. More
> frequently (still not common) a patient will have a gingival reaction to
> non-precious alloys. This was more frequent in the early days of PFM
> crowns, when nickle was commonly in the alloy. Gold is, of course, more
> easy to cast, machine and adjust.
> I don't know if there is any difference in bond strengths of
> ceramics to various substrates--perhaps the techs could comment.
> Steve
Since no techs have yet made comment, I guess you are stuck with the
opinion of a tech's husband. Most techs would much rather deal with the
gold (hi-noble) alloys. The NP metal can make a good crown, but is more
technique-sensitive. While Steve's answer is clinically and politically
correct, I have a slightly different take on the matter. From years of
listening to dental lab gossip, I can tell you that few dentists will allow
NP in their own or their family's mouths. From personal experience I can
tell you that NO lab tech would make a case for themselves out of NP unless
there were some special reason. It is not that NP is SO bad, it is just
that the difference in price per unit is not really that great. When I get
work done for myself, I gladly pay the difference ($40 or $50) to get
hi-noble (my insurance only covers NP.)
Nickel is not the only problem, your body can react to ANY metal, but
gold seems to be the safest. Beryllium can also cause a skin reaction and
could potentially be deadly should it somehow find its way into your lungs.
I hasten to say that I know of no documented case of a patient or even a
dentist getting beryllium disease and I pay great attention to such things.
My wife...now that's another matter.
Regards;
Vaughn
Below is an article my wife and I wrote for publication a while back:
Beryllium; The Stealth Poison
Beryllium is truly a space age metal. Silvery in color, it is lighter
than aluminum, yet stronger than steel. Once in short supply because of
cold war weapons programs, it is still prized for aerospace applications,
but is also increasingly finding application in consumer goods such as
certain high-end sporting goods and dental work.
For decades it has been known that beryllium can cause certain
illnesses. We now know that exposure to a vanishingly tiny amount of
beryllium can cause an incurable, sometimes fatal, lung disease in certain
sensitive people.
We think of beryllium as a "stealth poison" for many reasons. First,
the dose of beryllium that can cause Chronic Beryllium Disease (CBD) is so
tiny that it is absolutely undetectable by human senses. Second, there may
be a delay of many years between exposure to beryllium and the emergence of
any symptoms. Third, it is very possible that a victim will never even be
properly diagnosed, even though seriously ill. CBD often masquerades as
Sarcoidosis, and other lung conditions. Fourth, it is possible to be
exposed to beryllium without your knowledge. As more and more beryllium is
used in consumer goods and dental work, it will enter our lives via the
s{*filter*}metal recycling industry. A very small percentage of beryllium in a
metal you are polishing, cleaning, or cutting could be a hazard to your
health.
Is beryllium-containing dental work really a hazard to your health?
Well, it certainly is a hazard to the lab worker who makes your teeth, and
it represents a potential hazard to your dentist as he performs the final
grinding and polishing to fit the restoration in your mouth. Once in your
mouth, our present understanding is that beryllium-containing dental work is
probably safe except for a small possibility of gum irritation. That having
been said, few dental professionals that we have asked privately will allow
anything less than gold restorations in their own mouth. Do you deserve
less?
It really all comes down to money. There are two basic groupings of
metals that are used in dentistry; in the trade they are classed as
"non-precious" and "high noble". Both types of metal will do the job; the
difference is safety and price. As you might expect, your dental insurance
will only pay for the cheaper option. Depending on market conditions, the
wholesale price difference for the better metal is about thirty dollars per
tooth. Many dentists will be happy to allow you to pay the difference.
Alternatively, ask your dentist to specify a base metal that does not
contain beryllium and ask to see an "alloy classification certificate" that
specifies the composition of the metal alloy used. This certificate should
be supplied to your dentist by the dental lab that makes your restoration
and it should become a permanent part of your dental record.
The good news about Chronic Beryllium Disease is that it is totally
preventable. We do not need beryllium in our consumer goods, and we
especially do not need beryllium in our bodies. Many superior substitutes
exist. Let us leave beryllium to the few high-tech aerospace applications
where no reasonable substitutions exist, and where only those who are
properly informed and trained, and equipped will handle it.
