direct filling-gold seminar

dfg

1. Direct filling gold PRESENTED BY:DR.AJAY BABU GUTTI IIYEAR PG DEPARTMENT OF CONSERVATIVE DENTISTRY AND ENDODONTICS 1

2. CONTENTS: Introduction History of Direct filling gold Properties of pure gold Various forms of gold Gold foil Electrolytic precipitate Granular gold Removal of surface impurities: Degassing Compaction of direct filling gold Advantages, disadvantages, indication, contraindication 2

3. 3 Objectives of condensation Modes of condensation Gold condensers Principles of condensation Compaction technique General principles of cavity preparations Finishing and polishing of DFG Microleakage in DFG Class I, II Cavity design Class III cavity design Class IV cavity design Class V cavity design Conclusion

4. INTRODUCTION Direct golds are gold restorative materials that are manufactured for compaction directly into the prepared cavities. ( Sturdevant ) Gold is one of the oldest dental material, having been used for restoration of teeth. Earlier Phoenicians used gold wire to splint the teeth, and afterwards, Romans initiated making fixed bridges from gold strip. The use of gold in restorations remains considerable today, however, with an increasingly wide range of alternative materials available in dentistry, there is choice for a replacement of older and discolored fillings . 4

5. History of Direct Filling Gold : First evidence GREEK and ROMAN culture about 3000 B.C Sumerian, babylonian , assyrian tombs between 2000 and 3000 B.C Giovanni d’Arcoli – first evidence of use in dentistry as GOLD LEAF FILLINGS in 1483 5

6. Philip Pfaff (1715-1767), Dentist to FREDRICK the great of Prussia, used gold foil to cap the pulp. 1795-Robert woffendale - restoration purpose in AMERICA 1803-Edword Hudson used it as root canal filling. 1838-Dr. E.Meritt of pittsburg introduced hand mallet for compaction. In 1855 Robert . A . Arthur – cohesive or adhesive gold 6

7. PROPERTIES OF PURE GOLD: Soft, malleable ,ductile with percentage elongation of 12.8 %. Malleating produces sheets as thin as 0.13mm The best gold for restorations is about 999 parts in 1000 pure gold. Melting point 1063 , boiling point 2200 True density 19.3 gm/cm 3 . Apparent density range 14-15 gm/cm 3. Brinnels hardness number 25. C.T.E is 14.4 x 10 -6 / c High thermal conductivity of 0.710 cal/sec/cm 2 (/ C/cm) 7

8. Advantages Of Direct Filling Gold Gold foil restorations can last for a long-time if correctly done. The resilience of dentin and the adaptability of gold allow an almost perfect seal between the tooth structure and gold. Malleability of gold makes it possible to add gold in very small amounts that are building up the filling. Malleability also provides permanent self sealing margins. Coefficient of thermal expansion is similar to dentin, so therefore shows no shrinkage or expansion when placed in preparation. 8

9. Disadvantages Of Direct Filling Gold These restorations are technique sensitive, and to achieve excellence, great skill, patience and time is required. Improper placement of gold foil can damage the pulp or periodontal tissues. The welding technique, with or without a mallet, can do pulpal trauma. Because of the high thermal conductivity of gold, larger restoration can increase sensitivity. A larger restoration is very difficult to finish and polish. Galvonic shock 9

10. Indications For The Use Of Direct Filling Gold For Restoration of Tooth Preparations Direct filling gold restorations are indicated for incipient or early lesions, small in size present in non stress bearing areas. These may include: Small Class I preparations of all teeth Class II preparations with minimal proximal caries of premolars and on mesial surface of molars Class III preparations of all teeth specially when aesthetics is not important. Class V preparations of all teeth Class VI preparations of teeth where high occlusal stress is not present 10

11. CONTRAINDICATIONS FOR THE USE OF DIRECT FILLING GOLD Direct gold fillings are contraindicated in the following conditions: Young Patients, Limited Accessibility Size of the Lesion Poor Periodontal Condition Temperament of Patient Handicapped Patient, Aesthetics Heavy Occlusal Stresses Prognosis of the Tooth 11

12. Types of Direct Filling Gold Types of gold 1. Gold foil Sheets Gold foil cylinder Gold pellets Platinized gold foil Corrugated foil Laminated foil 2. Crystalline gold or electrolytic precipitated Mat gold Mat foil Electralloy 3. Powdered gold 4. E-Z Gold 5.Stopfgold 12

13. Gold Foil Also called fibrous gold . Available as sheets , pellets , cylinders , ropes and pre-condensed laminates of varying thickness. Gold leaf used in ornamentation , is about 0.1 μm thick. Dental foil (the usual No 4) is six times thicker, in other words 0.6 μm . It is available in several types: • Sheets • Gold foil cylinder • Gold pellets • Platinized gold foil • Corrugated gold foil • Laminated gold foil 13

14. Sheets: The gold foil is made by beating pure gold into thin sheets of size 10 × 10 cm (4 × 4 inch). The thickness of gold foil is 1.5 micron. The foils are supplied in books which are separated by thin paper pages. Each book has approximately twelve gold foils. The book of gold, either 1/8 or 1/10 of an ounce is ruled off and sizes are cut with the help of scissors 14

15. The book is divided into such sizes that represent 1/2, 1/4,1/8, 1/16, 1/32, 1/64 and 1/128 of a sheet of gold that weighs 4 grains No. 3 gold foil weighs 3 gm, No. 2 gold foil weighs 2 gm , No. 4 gold foil weighs 4 gm , and so on. Since size of 4 × 4 inch foil is too large for its use in preparation. Before insertion into the tooth preparation, it is cut, rolled into ropes, cylinders or pellet. 15

16. . 16 Gold foil cylinder: To make cylinder, one end of the ribbon is held with an instrument and rolled again and again until the other end is reached. Gold cylinders commonly used are of 1/4 and 1/8 of a sheet of gold. Cylinders of non-cohesive gold are used in the non-cohesive state and never annealed for cohesive use.

17. Gold pellets : They can be mechanical or handmade. To make gold pellets, a piece of foil is placed in the palm of the hand and each end is folded towards the center, this incompletely formed pellet is now transferred between the thumb and index finger and pellet is formed. Pellets are usually made cohesive before use. The rolled pellets can be stored in a gold foil box along with a cotton dipped in 18 percent ammonia 17

18. Platinized gold foil : This type of foil is made up by sandwiching a sheet of platinum between two sheets of gold foil and then hammered until a final platinized gold is formed. The platinum content in foil is 15%. Purpose of adding platinum to gold is to increase the hardness of the restoration. This makes its use in areas of high occlusal stress like cusp tips and incisal edge of anterior teeth. 18

19. Corrugated gold foil : Corrugated gold foil is made by putting thin sheets of paper in between gold foil sheets, and igniting them. Paper in between the gold foil gets burnt and charred leading to corrugated appearance of gold foil. Gold foil remains unharmed except it becomes corrugated because of the shriveling of the paper. 19

20. LAMINATED GOLD FOIL When gold foil is beaten from an ingot, its crystals are elongated in a specific direction, which allows forces to be better resisted in that direction. When two or more gold foils with crystals running in different direction are combined together, the resultant product is laminated gold foils which has more resistance to applied forces. 20

21. Electolytic precipitated gold This consist of the crystalline gold powder formed by electrolytic precipitation. The powder is formed into different shapes by heating at a temperature well below the melting point of gold. Diffussion of the particles occur at the point of contact so that the particles coalesce and grow. 21

22. In 1937,Rule first referred to crystal gold in his analysis of gold foil. This is electrolytic precipitated gold obtained by a process which is similar to electroplating but an accelerated rate The deposited material has a spongy structure with loosely arranged or fern like crystals. During subsequent heating process , branch ends of the crystals are rounded and tend to weld themselves together. These are available in the form of strips of medium widths (2.0mm)and wide widths(3.0mm)which can be cut to the size that fits the cavity. 22 MAT GOLD /CRYSTAL GOLD

23. MAT FOIL This is sandwich of mat gold placed in sheets of no.3/no.4 gold foil. The sandwich is sintered by heating to just below the melting point of gold and cut into strips of different widths. The ideas to use mat foil was to eliminate the need to veneer the restoration with a layer of gold foil . The gold foil cover holds the crystalline gold together while it is being condensed. 23

24. ELECTRALLOY/GOLD CALCIUM ALLOY This is an alloy of electrolytic gold and calcium. The calcium content is usually 0.1-0.5% by weight. Its purpose is to produce stronger restorations by dispersion hardening. For convenience , the product is sandwiched between two layers of gold foil. 24

25. POWDERED GOLD Powdered gold is in the form of minute particles . It can be obtained by atomization from a molten state or by chemical precipitation . In the latter process, gold is dissolved in aquaregia and precipitated by oxalic acid , sulphur dioxide or sodium nitrate . The average particle size is 15µ. As a powder the material is impractical to manipulate ,so is gathered into a conglomerate mass having a diameter of 1-3mms. 25

26. Introduced in 1962 by Baum & Lund. Commercially available as pellets of powdered gold wrapped in a gold foil know as” Goldent ”. Powdered particles are mixed with a soft wax and held in no.3 gold foil. Gold foil acts as container for powdered particles & facilitate their condensation. Each pellet is approximately 10 times more gold than a pellet of gold of comparable size. The ratio is 95% powder and 5% foil Hand compaction better than mechanical compaction for powdered gold Powdered gold and gold foil combination

27. It is similar to Goldent but with improved working properties marketed by Williams Gold Refining Company, New York, introduced in the late 1980s It is a mixture of pure gold powder and wax (less than 0.01% organic wax), wrapped in gold foil Its manipulative characteristics are similar to stiff amalgam yet more cohesive than gold foil hence the name e-z gold 27 E-Z gold EZ-Gold The New Goldent By Alperstein , Yearwood Jod 1996,21, 36-41

28. metallurgically similar to gold foil and powdered gold ( Goldent ) in that, when properly and thoroughly compacted, it has comparable properties: inertness (biocompatibility) and permanence. It is recommended for use in small class-I and class- V LESIONS It is less time consuming and more predictable Greater expected longevity and more favourable tissue response 28

29. Stopfgold : a new direct filling gold A new direct gold material that is considerably different from other direct golds has been available since 1989. The advantages are that the final restoration exhibits greater density than other forms of granular gold and has a 50% increase in shear strength when compared to gold foil. Clinical experience with the use of this new restorative material has been encouraging. 29

30. Degassing or Decontamination- Removal of contaminants so as to create more proximity between gold pieces. So we can say that degassing is a better term instead of annealing because in annealing, along with the removal of surface contamination, recrystallization also occurs but in degassing procedure only surface contamination is to be removed. It is specially done for non-cohesive gold , in which an ammonia layer is placed as a protective coating over the foil by the manufacturer, to prevent other gases and their oxides from contaminating the gold and to prevent clumping of pellets. 30 DEGASSING

31. Degassing [annealing] 31

32. a. In bulk method , en masse gold is placed on the mica tray and then heated over open gas or alcohol flame. The tray is heated until the gold pellets achieve the temperature of 650-700ºC. The advantages of bulk method are: • Takes less time • Convenient The disadvantages of bulk method are: • Sticking of gold pieces • Unused gold may be left and it can be wasted due to contamination. • Risk of overheating. 32

33. b. In piece method, the gold foil is held with an instrument and heated over clean blue flame of absolute or 90 percent ethyl alcohol. Temperature of the flame is about 1300°F. The heating is done until the gold becomes a dull red. Advantages of piece method: • Less wastage • Desired size of piece can be selected. Disadvantage of piece method: • Time consuming 33

34. 2. Electric annealer : In electric annealer , the gold is heated for 10 minutes at 850°F and then it is cooled for placing in the prepared tooth. One must take care to prevent overheating or the underheating as both of these can hamper qualities of gold. 34

35. 1. Heating over an open alcohol flame: 2. Heating in a mica tray over the alcohol flame: 3. Heating in an electric annealer : 35 The gold is heated to 850 F for ten minutes and then allowed to cool before it is placed in the cavity.

36. Consequences during degassing. 36

37. CONDENSATION Objectives of condensation 1-wedge initial pieces between dentinal walls, esp at starting point. 2-weld the gold pieces together by complete cohesion of the space lattice. 3-to minimize voids 4-strain hardening of gold materials which is due to cold working during condensation. 5-adapt material to cavity walls and floor 6-elastically deform the dentin of the cavity walls and floors 37

38. Modes of condensation: Hand instrument condensation- Initial confinement of the material within the cavity preparation . Condensation energy produce by this method is not sufficient to fulfill objective of condensation. Can be used as first step in two step condensation process 38

39. Pneumatic condensation- Vibrating condensers energized by compressed air. Pneumatic malletes consist of vibrating condenser and detachable tips run by compressed air. The air is carried through a thin rubber tubing attached to the handpiece . Controlling the air pressure by rheostat allows adjusting the frequency and amplitude of condensation strokes. Pneumatic malletes available with both straight and angled handpiece 39

40. Electronic condensation- Most efficient and controlled way of condensing materials the vibrating condenser heads have Intensity - 2 oz. to 15 lbs Frequency - 360 to 3600 cycles/minute. 40

41. Hand condenser and mallet- It requires a trained assistant Condensation by hand malleating is a team work in which operator directs the condenser and moves it over the surface while the assistant provides rhythmic blows from the mallets. Long handled condenser and leather faced mallets(50gm in wt ) are used 41

42. Gold condensers One common feature – faces are serrated with pyramidal shaped configurations Different types –: 1 – round condensers –used to start the restotaion or tie formation 2 – parallelogram condensor – to create bulk of the restoration. 3 – foot condensor – for cavosurface condensation and surface hardening of the restoration. method of condensation induces elastic compression of underlying dentin ,which adapts the material strongly after completion of compaction. 42

43. • Instruments for preparing and compacting or condensing the gold. • Instruments for proper finishing of the restoration. Preparation design for gold has following requisites: • Controlled outline form to meet the patient’s needs in terms of aesthetics • Mechanical retention • Accessibility for proper instrumentation • Pulp protection Operating Field: The operative field can be best isolated by rubberdam . 43

44. PRINCIPLES OF TOOTH PREPARATIONS FOR DIRECT FILLING GOLD RESTORATIONS There are a few fundamental pre-requisites to be considered to produce a lifetime gold restoration: • Proper tooth preparation. • Dry operative field. • Proper manipulation of the material. • Protection of supporting and surrounding tissues. 44

45. CAVITIES THAT ARE RESTORED USING DIRECT GOLD FILLING MATERIAL The class I Class II Loma Linda class III Woodbury class III Mandibular class III Class V 45

46. 46 33 ½ bur Wedelsteadt chisel Morse scaler Rubber cups No. 330 bur Instruments used

47. DIFFERENCE IN CAVITY PREPARATION OF AMALGAM, INLAY AND GOLD RESTORATION : SILVER AMALGAM Outline form is narrow as there is no surface involvement and walls converge occlusally. Cavity width-1/4 th of the intercuspal distance Cavity walls converge occlusally burs used-330 and 245 Occlusal cavosurface angle is 90 Gingival bevel-15 to 20 Undercuts in preparation improve retention of restoration. Proximal clearance minimally 0.5mm from adjacent tooth. Gingival seat should be supragingival. Secondary retention provided by grooves, slots, pins and amalgapins . Proximal walls only have a primary flare. Internal line angles are rounded. Reverse curve may be present in proximal outline. Beveling done only on the gingival cavosurface margin to remove unsupported enamel. CLASS II CAST GOLD INLAY Outline form is wide as suface involvement is more cavity walls are divergent. Width of cavity-1/3 rd of intercuspal distance. Cavity walls-slight occlusal divergence.Burs used 271, 169L, 8862. Occlusal cavosurface angle is 135-145. Gingival bevel is steeper-20-30 minimising cement line. No undercuts should be present. Proximally, more clearance can be accepted. Subgingival extension of gingival seat is acceptable if indicated. Secondary retention is provided by grooves, slots, skirts, collars and reverse bevel. Proximal margins show a primary and secondary flare. Internal line angles well defined. No reverse curve provided in the proximal outline. Bevels placed at occlusal and gingival cavosurface margins to provide frictional retention. 47

48. CLASS I CAVITY PREPARATION FOR GOLD RESTORATION Outline is kept small while providing convenience for instrumentation and restoration. Extended slightly beyond the lesion and it may be a simple circular design, oblong or triangular for a pit. Looks similar to that of amalgam restoration except that it looks more angular due to angular corners. Prepared with a no.330 bur (pear shaped bur) Pulpal depth-0.5mm into dentin. Walls extended minimally. Retentive undercuts placed in dentin using no. 33 ½ bur at slow speed or using angle former. Occlusal cavosurface margin slightly bevelled not more than 0.2mm width, using a small finishing bur or a flame shaped bur white stone. 40-45 bevel for metal margin burnishing. 48

49. Facial and lingual walls only extend into the contact area. Breaking contact -not necessary. Gingival margins should just clear the contact area and not extend subgingivally . Cavosurface margins beveled at 30-40 degree No. 330 bur(pear shaped). The outline includes entire defect and should be in the form of straight lines and definite curves. The proximal box same as that of amalgam cavity but conservative. All walls extended minimally. The cavity width is kept narrow not exceeding 1/5 th of the intercuspal distance. 49 CLASS II CAVITY PREPARATION FOR GOLD RESTORATION

50. Gingival floor showing reverse bevel 50 All line angles except axiopulpal line angle are kept very sharp. Can be done using angle formers or gingival marginal trimmers. A reverse bevel is placed on the gingival floor towards the axial wall. Triangular retentive grooves in facio axial and linguo axial line angle with base towards gingiva.

51. Class 3:Cavity preparations Various designs : Ferrier design Loma Linda Ingraham Lund and Baum Woodbury Minimal tooth separation (0.25mm – 0.50mm) is necessary for good access. This is done with a ferrier separator. 51

52. FERRIER DESIGN: Indicated for small carious lesions on proximal surfaces when thick labial, lingual and incisal walls remains. Facial approach recommended. Used in distal surfaces of anterior teeth. Triangular outline using no.1 round bur. 33 1/2 inverted cone bur extends outline. From the proximal facial aspect, the facial wall follows facial contour of the tooth and meets gingival margin in a slight obtuse angle 52

53. The gingival margin kept below free gingiva, and is straight facio -lingually. Meets the facial wall in obtuse angle, and the lingual wall in acute angle. The lingual wall is straight at the gingival 2/3 rd and curves abruptly in the incisal 1/3 rd to meet the incisal angle. 53

54. The incisal margin extends just incisal to the contact area and meets the facial and lingual walls in a smooth curve. The axial wall -0.5mm into dentin. RESISTANCE FORM : Flat axial wall, buccal, lingual divergent wall RETENTION FORM : Acute axio -gingival line angle(Small angle formers) and an incisal undercut placed into dentin directed facio incisally.( bibeveled hatchet) CONVENIENCE FORM : Finally wedlestaedt chisel bevel the cavo surface margins. This ,removes any unsupported enamel and allows esthetic blending. 54

55. LOMA LINDA DESIGN : Lingual access Indicated in esthetic areas ½ round bur used with lingual approach Labial and gingival walls- base of 33 1/2 bur Lingual wall-side of same bur Outline- triangular with rounded corners No lingual wall, but lingual margin Gingival margin same as Ferriers Cavosurface bevels, flares not needed Three retentive grooves 1) Incisal point angle, 2) Linguo gingival DEJ, 3) Facio axio - gingival point angle 55

56. INGRAHAM DESIGN: Incipient proximal region with esthetic concern Oral hygiene, low caries/plaque index essential Outline form Parallelogram Labial, incisal margin not visible externally Gingival margin clears contact area with minimal extension Lingual margin extends beyond lingual marginal ridge Axial walls flat, right angle to labial wall Retention grooves – inciso axial and gingivo axial line angles, with decreased depth towards labial surface Lesion entered with No: 1 round bur followed by No: 168 bur Retention grooves with inverted cone bur Bevels placed on all margins with GMT 56

57. Class 5 : Cavity preparation Proper isolation is necessary. The no. 212 clamp is modified before placement Most commonly used design FERRIER’S Outline - trapezoidal in shape. NO:33 ½ bur used to begin Same bur – Occlusal, gingival, mesial, distal, axial walls 57

58. Occlusal wall is longer and straight. Gingival wall is shorter than the occlusal due to narrowing of tooth gingivally . This parallels the occlusal wall. The mesial and distal walls parallel the proximal line angle of the tooth and diverge facially meeting the occlusal and gingival margins in sharp angles. The axial wall is located in dentin and is 1mm deep occlusally and 0.75mm deep gingivally . 58

59. Retention by acute axio gingival line angle, (hoe or a monangle chisel) sharp line and point angle. A slight cavosurface bevel is placed on all enamel margins using the wedelstaedt chisel. No bevel given on gingival wall if it extends to cementum . 59

60. VARIATIONS IN CLASS V CAVITY DESIGN 60 CURVED OCCLUSAL OUTLINE DISPLAYING LESS GOLD CURVED GINGIVAL OUTLINE WHEN GINGIVAL TISSUE IS STRONG AND ADHERENT

61. . 61 PARTIAL MOON SHAPED (CRESCENT SHAPED) CAVITY PREPARATION

62. 62 CLASS V CAVITY WITH PEN HANDLE EXTENSION Force of condensation should be at 45 to the cavity walls and floors. The force of condensation must be at 90 to previously condensed gold. 62 PRINCIPLES OF CONDENSATION

63. Whenever condensing a piece of gold always start at a point on one side and proceed in a straight line to another point on the opposite side, then back to the original side on a different straight line. During these disciplined movements, the condenser should overlap atleast 1/4 th of the previously condensed areas. This ensures that each portion of the gold increment has been cold worked and welded and there are no voids present. This process is called “stepping” . 63

64. Use the minimal thickness of pellet possible, provided that the condensers will not penetrate it. Energy of condensation :- It is more effective to utilize a lesser amount of energy inside the cavity preparation and to increase energy of condensation gradually as the step-by-step build –up proceeds to surface. When inserting pieces of direct gold materials, condensation can be either from one periphery of the increment to the other, or from the center of the increment to the peripheries Condensation of precipitated types of direct gold materials should be started by hand in a rocking again. When the material is unyielding to the hand condenser, mechanical condensation can proceed 64

65. COMPACTION TECHNIQUE Gold foil cut to the size and shape of the cavity is spread out in a smooth concave form by hand Gold is adapted lightly to the cavity walls, line angles and point angles by hand pressure Gold is held steady by a holding instrument, and a condenser of desirable size is used to begin malleting in the centre of the mass Slowly, the condenser is moved to the periphery along straight lines using the stepping process 65

66. General steps for direct gold restorations 1)Build up of the restoration Tie formation : This involves connecting two opposing point angles or starting points filled with gold with a transverse bar of gold. This tie forms the foundation for any restoration in direct gold. 66

67. 2. Banking of the walls : Consist of converging each wall from its floor or axial wall to cavosurface margin with a direct gold material. It should be done simultaneously on the surrounding walls of the preparations. 67 3. Shoulder formation : This consist of connecting two opposing walls with the direct gold material to completely fill the restorations.

68. MARGINATION Using sharp instruments(knives and files), moving from the gold surface to the tooth surface, to eliminate excess in small increments at a time. Should not cut or displace a large chunk of direct gold marginally-may displace the whole restoration or cause irreversible damage marginally. Margination process is done till it is possible to visualize the original outline of the cavity preparation. Necessary to alternate between burnishing and margination, as margination may expose soft gold or voids. Burnishing can correct these small discripencies . 68

69. 69 BURNISHING This process follows margination as a mean of closing marginal discrepancies as well as strain hardening the surface. CONTOURING In this process, an effort is made to create a proper anatomy to coincide with that of the tooth and to be compatable with that of the opposing, contacting and occluding teeth. It is accomplished using knives, files, or finishing burs. If contouring involves margins, they should be reburnished before final contouring. Further burnishing of non-marginal parts of the restoration may also be needed during the contouring procedure.

70. ADDITIONAL BURNISHING Done for the purpose of fulfilling previously mentioned objectives. 70 FINISHING AND POLISHING Minimal finishing and polishing will be required with a properly surface hardened, marginated , and contoured restoration. However,some finishing may be done using precipitated chalk or tin oxide powder on soft bristle brushes. Burnishing is the first step in finishing of gold restoration. For occlusal surface, a Spartley burnisher or ball burnisher is moved from metal to tooth surface. A Spartley blade carver is used in embrasures for proximal restorations. For optimum contour intruments used are Morse Scaler, Jones Knife, or Cleiod discoid carver

71. Any excess is removed using abrasive strips and disks , mostly cuttlefish used n the disk in degrading grade Excess gold in gingival area is removed using the contrabevel end of Wedelstedt chisel Polishing is done with tin oxide or extra fine silex is applied with a rubber cup and should be confined to restoration surface with air coolants 71

72. Microleakage around dfg They adapt to the cavity walls most efficiently. The decreased marginal leakage can be attributed to good adaptability of gold to preparation walls because of – 1- high malleability and ductility 2- short bevel on the cavosurface margins facilitates burnishing, contouring, and polishing thereby promoting close adaptation at the cavity restoration interface. 72

73. 73

74. Conclusion Though Gold is biocompatible, and produces a efficient sealing and has good marginal integrity, its unaesthetic appearance, longer chair time, proper isolation, technique sensitivity, high force required to condense the gold foil, all results for its limitations and hence the future of this Direct gold is definitely fading and to be precise it has already faded with the advent of the superior , esthetic composites and other restorative materials. 74

75. BIBLIOGRAPHY Sturdevant , Art and science of operative dentistry Phillips science of dental materials Sikri Marzouk , Modern theory and practice Ramya Raghu Gilmore 75

76. THANK YOU …………. 76