DIRECT FILLING DIRECT FILLING GOLDGOLD

Submitted By:Deepika Bali

Direct golds are those gold restorative materials Direct golds are those gold restorative materials that are manufactured for directly compacting that are manufactured for directly compacting them in to the prepared cavities.them in to the prepared cavities.

This noble metal is a superior restorative material This noble metal is a superior restorative material

for small defects and lesions in teethfor small defects and lesions in teeth..

Pure gold has been a metal of special intrinsic and practical Pure gold has been a metal of special intrinsic and practical value.value.

In its pure form, gold has unusual ability to cohere to itself at In its pure form, gold has unusual ability to cohere to itself at room temperature.room temperature.

Gold is quite soft and in a compressible form, increments can Gold is quite soft and in a compressible form, increments can be welded by pressure in to solid metal mass inside a be welded by pressure in to solid metal mass inside a prepared tooth cavity. The metallic bonding between prepared tooth cavity. The metallic bonding between overlapped increments produces the overlapped increments produces the direct gold restoration.direct gold restoration.

It requires care and cleanliness in handling the metal and skill It requires care and cleanliness in handling the metal and skill necessary in use , cohesive gold has acquired a reputation necessary in use , cohesive gold has acquired a reputation as a material that embodies perfection in hands of skillful, as a material that embodies perfection in hands of skillful, well trained operative dentist.well trained operative dentist.

Types of Direct Filling GoldTypes of Direct Filling Gold

1.1. Gold foilGold foil

A.A. SheetsSheets

B.B. Pellets (hand rolled & preformed)Pellets (hand rolled & preformed)

C.C. CylindersCylinders

D.D. Corrugated foilCorrugated foil

E.E. Platinized foilPlatinized foil

F.F. Laminated foilLaminated foil

2.2. Electrolytic precipitated goldElectrolytic precipitated gold

A.A. Mat gold Mat gold

B.B. Mat foil Mat foil

C.C. Gold calcium alloy Gold calcium alloy

2.2. Powdered gold Powdered gold

A.A. GoldentGoldent

Gold Foil Gold Foil Gold foil is also called fibrous gold .It is available as Gold foil is also called fibrous gold .It is available as

sheets , pellets , cylinders , ropes and sheets , pellets , cylinders , ropes and precondensed laminates of varying thickness.precondensed laminates of varying thickness.

A.A. Gold foil sheetsGold foil sheets: these are manufactured by : these are manufactured by beating or rolling pure gold ingots into thin beating or rolling pure gold ingots into thin sheets. Gold foil is cut into 4x4” sheets. These sheets. Gold foil is cut into 4x4” sheets. These sheets are seperated by thin paper and bound in sheets are seperated by thin paper and bound in books containing 1/10 or 1/20 ounces of gold. books containing 1/10 or 1/20 ounces of gold. No.4 gold foil is the standard size and weighs 4 No.4 gold foil is the standard size and weighs 4 grains. No. 3 gold foil weighs 3 grains. No. 2 gold grains. No. 3 gold foil weighs 3 grains. No. 2 gold foil weighs 2grains.since these sheets are too foil weighs 2grains.since these sheets are too large for restorative purposes, the are rolled into large for restorative purposes, the are rolled into pellets or cylinders before insertion into cavity pellets or cylinders before insertion into cavity preparationpreparation..

B.B. Gold foil pelletsGold foil pellets: these may be hand rolled or : these may be hand rolled or commercially produced from a no. 4 gold foil commercially produced from a no. 4 gold foil sheets. Small sections of the gold foil sheets sheets. Small sections of the gold foil sheets (1/32”, 1/64”, 1/128”) are cut and rolled into (1/32”, 1/64”, 1/128”) are cut and rolled into pellet form.pellet form.

C.C. Gold foil cylindersGold foil cylinders: these may also be hand : these may also be hand rolled or preformed. Usually larger segments rolled or preformed. Usually larger segments of sheet (1/2”,1/4’, 1/8”) are cut and rolled of sheet (1/2”,1/4’, 1/8”) are cut and rolled into cylinders.into cylinders.

D.D. Corrugated gold foilCorrugated gold foil: these are manufactured : these are manufactured by placing thin sheets of paper in between by placing thin sheets of paper in between the gold foil sheets and igniting them . The the gold foil sheets and igniting them . The paper burns and gets charred while the gold paper burns and gets charred while the gold foil becomes corrugated .foil becomes corrugated .

E.E. Platinized gold foilPlatinized gold foil: this is a sandwich of gold and : this is a sandwich of gold and platinum with the platinum content being 15%. It platinum with the platinum content being 15%. It may be manufacture in one of the following may be manufacture in one of the following ways:ways:

One sheet of pure platinum foil may be sandwich One sheet of pure platinum foil may be sandwich between 2 sheets of gold. These are then hammered between 2 sheets of gold. These are then hammered to form a platinized gold foil.to form a platinized gold foil.

Layers of platinum of gold are rolled over together to Layers of platinum of gold are rolled over together to bring about their fusion following which they are bring about their fusion following which they are beaten to achieve desired thickness . beaten to achieve desired thickness .

Addition of platinum increases the strength and wear Addition of platinum increases the strength and wear resistance of the restoration. Platinized gold foil may be resistance of the restoration. Platinized gold foil may be used for areas of stress concentration like incisal edges used for areas of stress concentration like incisal edges

and cusp tips.and cusp tips.

F.F. Laminated gold foilLaminated gold foil: when gold foil is beaten : when gold foil is beaten from an ingot, its crystals are elongated in a from an ingot, its crystals are elongated in a specific direction. A combination of two or three specific direction. A combination of two or three foils with crystals running in different direction foils with crystals running in different direction is called a laminated gold foil. Since the crystals is called a laminated gold foil. Since the crystals run in all direction, laminated gold foil are run in all direction, laminated gold foil are stronger and can be used in stress-bearing stronger and can be used in stress-bearing areas like cusp tips and incisal edges.areas like cusp tips and incisal edges.

Electrolytic precipitated Electrolytic precipitated gold gold

This is a crystalline gold powder formed by This is a crystalline gold powder formed by electrolytic precipitation. The powder is made electrolytic precipitation. The powder is made into different shapes by sintering at an into different shapes by sintering at an elevated temperature well below the melting elevated temperature well below the melting point of gold.point of gold.

A.A. Mat goldMat gold : this is a crystalline electrolytically : this is a crystalline electrolytically precipitated gold that is formed into strips. This form precipitated gold that is formed into strips. This form is easy to use for building the internal bulk of the is easy to use for building the internal bulk of the restoration because of ease of compaction. But mat restoration because of ease of compaction. But mat gold is loosely packed so it shows numerous voids gold is loosely packed so it shows numerous voids between the particles. Hence it is not recommended between the particles. Hence it is not recommended for the external surface of the restoration as it for the external surface of the restoration as it become pitted. become pitted.

B.B. Mat foilMat foil : this consists of sandwich of : this consists of sandwich of electrolytically precipitated gold powder electrolytically precipitated gold powder between two sheets of No. 3 gold foil which is between two sheets of No. 3 gold foil which is sintered and cut into strips. This purpose of sintered and cut into strips. This purpose of sandwiching mat gold between foil sheets is sandwiching mat gold between foil sheets is to eliminated the need to veneer the to eliminated the need to veneer the restoration the layer of foilrestoration the layer of foil..

C.C. Gold calcium alloyGold calcium alloy : this the another form : this the another form of electrolytically precipitated which is of electrolytically precipitated which is alloyed with 0.1% calcium. It is commercially alloyed with 0.1% calcium. It is commercially available as Electralloy RV. The addition of available as Electralloy RV. The addition of calcium produces a stronger restoration by calcium produces a stronger restoration by dispersion strengthening . This is sintered so dispersion strengthening . This is sintered so as to make the gold into strip formas to make the gold into strip form

Powdered goldPowdered gold Powdered gold is made by a combination of Powdered gold is made by a combination of

chemical precipitation and atomization with an chemical precipitation and atomization with an average particle size of 15 m. average particle size of 15 m.

Since powders are difficult to manipulate the Since powders are difficult to manipulate the particles are mixed together in wax and cut in to particles are mixed together in wax and cut in to pieces and wrapped in gold foils as pellets. pieces and wrapped in gold foils as pellets.

This is available as Goldent or Williams E-Z Gold.This is available as Goldent or Williams E-Z Gold.

Properties of direct Properties of direct filling gold filling gold

Pure gold is soft, malleable and ductile and does not Pure gold is soft, malleable and ductile and does not oxidize under normal atmospheric conditions.oxidize under normal atmospheric conditions.

It has a rich yellow color and a strong metallic lustre. It has a rich yellow color and a strong metallic lustre.

Gold fusses at 1063Gold fusses at 106300 c and boils at 2200 c and boils at 220000 c. c.

Density of pure gold is 19 – 19.3g/cmDensity of pure gold is 19 – 19.3g/cm33 but this is but this is reduce by voids incorporated during restoration to14 reduce by voids incorporated during restoration to14 -15g/cm-15g/cm33

The brinnell hardness no. for gold is 25 this makes it The brinnell hardness no. for gold is 25 this makes it very soft. However during compaction the hardness very soft. However during compaction the hardness increases 258-82 making it a strong material.increases 258-82 making it a strong material.

The coefficient of thermal expansion of gold is 14.4 The coefficient of thermal expansion of gold is 14.4 x 10x 10-6-6/ /

00C which is close to that of tooth C which is close to that of tooth

structure(11.4 x 10structure(11.4 x 10-6-6/ / 00C)C)

Even small amount of impurities can affect the Even small amount of impurities can affect the mechanical properties of gold. Very small amount mechanical properties of gold. Very small amount of lead, bismuth, mercury adversely affect the of lead, bismuth, mercury adversely affect the

properties of gold. However, minute amount of properties of gold. However, minute amount of calcium, palladium, and platinum can improve the calcium, palladium, and platinum can improve the properties of gold.properties of gold.

It can be cold welded at room temperature.It can be cold welded at room temperature.

Gold exhibits excellent marginal integrity and Gold exhibits excellent marginal integrity and biocompatibility with the oral tissues.biocompatibility with the oral tissues.

Advantages of direct goldAdvantages of direct gold1.1. When properly placed, direct gold is the most durable When properly placed, direct gold is the most durable

restorative material.restorative material.2.2. As pure gold is a noble metal, it does not undergo tarnish As pure gold is a noble metal, it does not undergo tarnish

or corrosion in the oral cavity.or corrosion in the oral cavity.3.3. They are insoluble in the oral fluids and exhibit thermal They are insoluble in the oral fluids and exhibit thermal

expansion similar to that of dentin.expansion similar to that of dentin.4.4. When proper case selection is done and the cavity When proper case selection is done and the cavity

preparation is kept ideal, it is atraumatic to the dental preparation is kept ideal, it is atraumatic to the dental pulp and supporting structures.pulp and supporting structures.

5.5. Direct gold exhibits good adaptation to the cavity walls. Direct gold exhibits good adaptation to the cavity walls. Being ductile it can be burnished against the cavity Being ductile it can be burnished against the cavity margins to create excellent marginal integrity.margins to create excellent marginal integrity.

6.6. The surface of direct gold can be polished well and the The surface of direct gold can be polished well and the smoothness will last indefinitely .smoothness will last indefinitely .

7.7. The density and hardness of compacted gold provide The density and hardness of compacted gold provide adequate compressive strength.adequate compressive strength.

Disadvantages of Disadvantages of direct golddirect gold

1.1. The yellow colour of pure gold is not esthetically The yellow colour of pure gold is not esthetically acceptable to most of the patients.acceptable to most of the patients.

2.2. The manipulation of gold is very exacting and The manipulation of gold is very exacting and difficult to master.difficult to master.

3.3. It is time consuming.It is time consuming.

4.4. Expensive material.Expensive material.

5.5. Thermal conductivity of gold is high. So pulp Thermal conductivity of gold is high. So pulp protection is necessary under gold restoration.protection is necessary under gold restoration.

IndicationsIndications1.1. Class 1 CavityClass 1 Cavity : Direct gold is indicated for small carious : Direct gold is indicated for small carious

lesions in pits and fissures of posterior teeth and lingual lesions in pits and fissures of posterior teeth and lingual surfaces of anterior teeth.surfaces of anterior teeth.

2.2. Class 2 cavityClass 2 cavity : Direct gold is indicated for minimal : Direct gold is indicated for minimal proximal caries in posterior teeth especially premolars when proximal caries in posterior teeth especially premolars when marginal ridges are not subjected to heavy occlusal marginal ridges are not subjected to heavy occlusal stresses.stresses.

3.3. Class 3 CavityClass 3 Cavity : Can be used for small carious defects in : Can be used for small carious defects in anterior teeth when the defect is only on the proximal anterior teeth when the defect is only on the proximal surface and esthetics will not be affected.surface and esthetics will not be affected.

4.4. Class 5 CavityClass 5 Cavity : For minimal caries in the Cervical one third : For minimal caries in the Cervical one third of teeth direct gold can be used. Also for small abrasion, of teeth direct gold can be used. Also for small abrasion, erosion or abfraction defects on the facial surfaces of teeth.erosion or abfraction defects on the facial surfaces of teeth.

5.5. Class 6 CavityClass 6 Cavity : For restoration involving incisal edges or : For restoration involving incisal edges or cusp tips direct gold can be used, provided there is no cusp tips direct gold can be used, provided there is no heavy occlusal stress.heavy occlusal stress.

6.6. Defective Crown margin Defective Crown margin : It can be repaired with direct : It can be repaired with direct gold.gold.

ContraindicationsContraindications1.1. Young PatientsYoung Patients : Because of presence of large pulp : Because of presence of large pulp

chambers it is contraindicated as the malleting forces of chambers it is contraindicated as the malleting forces of direct gold may not be tolerated by the pulp.direct gold may not be tolerated by the pulp.

2.2. Poor periodontal statusPoor periodontal status : In periodontally weakened : In periodontally weakened teeth, direct gold is not employed because of questionable teeth, direct gold is not employed because of questionable prognosis. prognosis.

3.3. Heavy occlusal stresses Heavy occlusal stresses : For moderate to large carious : For moderate to large carious defects direct gold is not used as it can not withstand defects direct gold is not used as it can not withstand heavy occlusal forces.heavy occlusal forces.

4.4. EconomicsEconomics : It is not indicated when cost is the limiting : It is not indicated when cost is the limiting factor.factor.

5.5. Handicapped PatientsHandicapped Patients : It is contraindicated as long : It is contraindicated as long appointments are necessary.appointments are necessary.

6.6. Esthetics Esthetics : When esthetic is the main concern it is not : When esthetic is the main concern it is not recommended.recommended.

7.7. Access and isolation difficultiesAccess and isolation difficulties..

Manipulation of direct filling Manipulation of direct filling goldgold

There are two processes involved;There are two processes involved; DegassingDegassing compactioncompaction

Degassing Degassing [annealing][annealing]

DegassingDegassing is the process of heating is the process of heating direct gold materials to remove the direct gold materials to remove the surface contaminants. surface contaminants.

It can be achieved by It can be achieved by Heating the gold foil over pure ethanol Heating the gold foil over pure ethanol

flame.flame. Heating in a mica tray mounted over an Heating in a mica tray mounted over an

alcohol lampalcohol lamp Heating in a electric annealer.Heating in a electric annealer.

1. 1. Heating over an open alcohol flameHeating over an open alcohol flame::In this method each piece of direct gold is held in the In this method each piece of direct gold is held in the middle zone of an alcohol flame for 3-5 sec before middle zone of an alcohol flame for 3-5 sec before inserting into the cavity preparation.inserting into the cavity preparation.

2. 2. Heating in a mica tray over the alcohol flameHeating in a mica tray over the alcohol flame::This is a bulk method where several gold pellets are This is a bulk method where several gold pellets are degassed in a mica tray held over the alcohol flame. degassed in a mica tray held over the alcohol flame. This method tales less time but care should be taken to This method tales less time but care should be taken to prevent the gold pieces from sticking to each other.prevent the gold pieces from sticking to each other.

33. Heating in an electric annealer . Heating in an electric annealer ::

In this the desired amount of gold is placed in the In this the desired amount of gold is placed in the compartments of the annealer and the lid is closed. The compartments of the annealer and the lid is closed. The gold is heated to 850gold is heated to 850 0 0 F for ten minutes and then allowed to F for ten minutes and then allowed to cool before it is placed in the cavity.cool before it is placed in the cavity.

Hazards during Hazards during degassing.degassing.

1.1. OverheatingOverheating – If the gold is heated for – If the gold is heated for prolonged periods of time or to high prolonged periods of time or to high temperatures, excessive sintering and temperatures, excessive sintering and contamination from the tray, instrument or flame contamination from the tray, instrument or flame can occur. This results in recrystallization and can occur. This results in recrystallization and grain growth, decrease plasticity of the material grain growth, decrease plasticity of the material and improper compaction of the gold. and improper compaction of the gold.

2.2. UnderheatingUnderheating – If the gold is not heated – If the gold is not heated adequately it results in incomplete removal of adequately it results in incomplete removal of surface impurities. This leads to poor cohesion surface impurities. This leads to poor cohesion between the gold pieces on condensation between the gold pieces on condensation causing pitting and porosity in the final causing pitting and porosity in the final restoration.restoration.

Certain Principles to be Certain Principles to be followed for followed for

compaction of direct compaction of direct goldgold1.1. The force of condensation should be at 45The force of condensation should be at 4500 to the cavity to the cavity

walls and floors. This produces maximum adaptation of walls and floors. This produces maximum adaptation of the gold into all details of cavity preparation.the gold into all details of cavity preparation.

2.2. The force of condensation must be at 90The force of condensation must be at 9000 to previously to previously condensed gold to prevent displacement of the already condensed gold to prevent displacement of the already condensed pieces of gold.condensed pieces of gold.

3.3. Whenever condensing a piece of direct gold, always start Whenever condensing a piece of direct gold, always start at a point on one side and proceed in a straight line to at a point on one side and proceed in a straight line to another point on the opposite side, then back to the another point on the opposite side, then back to the original side on a different straight line. During these original side on a different straight line. During these movements, the condenser should overlap at least half of movements, the condenser should overlap at least half of the previously condensed area. This process is called the previously condensed area. This process is called “stepping”. This ensures maximum adaptations of the “stepping”. This ensures maximum adaptations of the gold to the cavity walls and also cold welds. Each gold to the cavity walls and also cold welds. Each increment of gold thus reducing the voids.increment of gold thus reducing the voids.

4.4. Minimally sized increments of gold should be used.Minimally sized increments of gold should be used.

Modes of condensation:Modes of condensation:1.1. Hand instrument condensation- Hand instrument condensation- TheThe energy energy

produced by this method is not sufficient to fulfill the produced by this method is not sufficient to fulfill the objective of condensation. However, it can be used objective of condensation. However, it can be used only as a first step in a two step condensation only as a first step in a two step condensation process, simply to effect the initial confinement of process, simply to effect the initial confinement of the material within the cavity preparation.the material within the cavity preparation.

2.2. Pneumatic condensation-Pneumatic condensation- This involves the use of This involves the use of vibrating condensers energized by compressed air.vibrating condensers energized by compressed air.

3.3. Electronic condensation- Electronic condensation- ThisThis is the most is the most efficient and controlled way of condensing materials efficient and controlled way of condensing materials the vibrating condenser heads can have an intensity the vibrating condenser heads can have an intensity or amplitude from 2 oz. to 15 lbs. and a frequency of or amplitude from 2 oz. to 15 lbs. and a frequency of 360 to 3600 cycles per minute.360 to 3600 cycles per minute.

4.4. Hand condenser and malletHand condenser and mallet- - It requires a trained It requires a trained assistant to apply the condensation energy with a assistant to apply the condensation energy with a mallet. This in turn must be in coordination with mallet. This in turn must be in coordination with locating the hand condensers by the operator to the locating the hand condensers by the operator to the inside of the cavity preparation.inside of the cavity preparation.

General principles of cavity General principles of cavity preparations for direct gold preparations for direct gold

restorationsrestorations1.1. The outline formThe outline form : Should include all structural defects : Should include all structural defects

and margins must be placed on sound tooth structure. and margins must be placed on sound tooth structure. The outline should be smooth and designed to be The outline should be smooth and designed to be esthetically pleasing.esthetically pleasing.

2.2. Resistance form Resistance form : Is achieved by creating flat pulpal : Is achieved by creating flat pulpal floors perpendicular to occlusal forces. The walls must be floors perpendicular to occlusal forces. The walls must be smooth and flat. Enamel walls must be supported by smooth and flat. Enamel walls must be supported by sound dentin the cavity width must be minimal while sound dentin the cavity width must be minimal while providing adequate convenience form.providing adequate convenience form.

3.3. Retention formRetention form : Is achieved by parallel or slight : Is achieved by parallel or slight occlusal convergence of the facial and lingual walls. The occlusal convergence of the facial and lingual walls. The depth of the cavity should be 0.5 mm into dentin. The depth of the cavity should be 0.5 mm into dentin. The presence of sharp internal line angles resist the presence of sharp internal line angles resist the movement of the restorations.movement of the restorations.

4.4. Convenience FormConvenience Form : Requires suitable access and a dry : Requires suitable access and a dry field. The width of the cavity should be minimal. Sharp field. The width of the cavity should be minimal. Sharp internal line and point angles in dentin serve as internal line and point angles in dentin serve as convenient “starting” points for compaction of direct gold.convenient “starting” points for compaction of direct gold.

Class 1:Cavity preparations for Class 1:Cavity preparations for direct gold restorationsdirect gold restorations

The outline form is kept as small as possible while The outline form is kept as small as possible while providing convenience for instrumentation and providing convenience for instrumentation and restoration. restoration.

It is extended slightly beyond the lesion and it may be It is extended slightly beyond the lesion and it may be a simple circular design, oblong, or triangular for a pit. a simple circular design, oblong, or triangular for a pit.

The preparation is done with a no. 330 bur. The preparation is done with a no. 330 bur. The pulpal depth is .5mm in to dentin.The pulpal depth is .5mm in to dentin. The walls are extended minimally.The walls are extended minimally. Retentive undercuts are placed in dentin using a no. Retentive undercuts are placed in dentin using a no.

33331/21/2 Bur at a slow speed or using angle formers. Bur at a slow speed or using angle formers. Occlusal cavosurface margin is slightly beveled not Occlusal cavosurface margin is slightly beveled not

more than 0.2mm in width using a small finishing bur more than 0.2mm in width using a small finishing bur or a flame shaped white stone. This allows a 40-45 or a flame shaped white stone. This allows a 40-45 degree metal margin that can be burnished well degree metal margin that can be burnished well against the tooth.against the tooth.

Outline form for a class 1 pit cavity in Outline form for a class 1 pit cavity in a mandibular premolara mandibular premolar

Class 2:Cavity preparationClass 2:Cavity preparation1.1. The preparation is done with a no. 330 bur(pear shaped). The The preparation is done with a no. 330 bur(pear shaped). The

outline includes entire defect and should be in the form of outline includes entire defect and should be in the form of straight lines and definite curves.straight lines and definite curves.

2.2. The proximal box is also prepared same as that of amalgam The proximal box is also prepared same as that of amalgam cavity preparation except it is more conservative. cavity preparation except it is more conservative.

3.3. All walls of the proximal box are extended minimally into the All walls of the proximal box are extended minimally into the respective embrasures.respective embrasures.

4.4. The cavity width is kept very narrow not exceeding 1/5 the The cavity width is kept very narrow not exceeding 1/5 the intercuspal distance.intercuspal distance.

5.5. Facial and lingual walls of the proximal box should only extend Facial and lingual walls of the proximal box should only extend into the contact area.into the contact area.

6.6. Breaking the contact is not necessary.Breaking the contact is not necessary.7.7. Gingival margins should just clear the contact area and not Gingival margins should just clear the contact area and not

extend subgingivally.extend subgingivally.8.8. Cavosurface margins are beveled at 45 degree to the enamel Cavosurface margins are beveled at 45 degree to the enamel

walls.walls.9.9. All line angles except axiopulpal line angle are kept very sharp.All line angles except axiopulpal line angle are kept very sharp.10.10. A reverse bevel is placed on the gingival floor towards the A reverse bevel is placed on the gingival floor towards the

axial wall.axial wall.

Gingival floor showing reverse bevelGingival floor showing reverse bevel

Class 3:Cavity Class 3:Cavity preparationspreparations

FERRIER DESIGNFERRIER DESIGN

Before commencing the cavity preparation minimal tooth separation (0.25mm – 0.50mm) is necessary for good access. This is done with a ferrier separator.

This design is indicated for small carious lesions on proximal surfaces when thick labial, lingual and incisal walls remains.

Access is done from the facial approach using a no.1 round bur. A no.331/2 inverted cone bur extends the outline form. When viewed from the proximal aspect, the facial wall follows the facial contour of the tooth and meets the gingival margin in a slight obtuse angle

The gingival margin is kept just apical to the crest of the free gingiva. It is straight faciolingually. It meets the facial wall in a sharply defined obtuse angle, and the lingual wall in a sharply defined acute angle.

The lingual wall is straight gingivally and curves abruptly in the incisal 1/3rd to meet the incisal angle.

The incisal margin extends just incisal to the contact area and The incisal margin extends just incisal to the contact area and meets the facial and lingual walls in a smooth curve.meets the facial and lingual walls in a smooth curve.

The axial wall is located 0.5mm into dentin. To provide enough The axial wall is located 0.5mm into dentin. To provide enough resistance form, the internal aspect of the preparation are resistance form, the internal aspect of the preparation are precisely instrumented .precisely instrumented .

The dentinal portion of the wall planed using a hoe and angle The dentinal portion of the wall planed using a hoe and angle former. A bibeveled hatchet establishes the incisal former. A bibeveled hatchet establishes the incisal retention point. Small angle formers are then used to retention point. Small angle formers are then used to accentuate the point angles and the axiogingival angle.accentuate the point angles and the axiogingival angle.

Finally the wedlestaedt chisel is used to bevel the cavo Finally the wedlestaedt chisel is used to bevel the cavo surface margins. This creates maximum convenience form, surface margins. This creates maximum convenience form, removes any unsupported enamel and allows esthetic removes any unsupported enamel and allows esthetic blending of the gold restorationsblending of the gold restorations..

Class 5 : Cavity Class 5 : Cavity preparationpreparation

1.1. Proper isolation is necessary.Proper isolation is necessary.2.2. The no. 212 clamp is modified before placement to The no. 212 clamp is modified before placement to

allow proper access and isolation of the class 5 allow proper access and isolation of the class 5 lesion.lesion.

3.3. It trapezoidal in shape.It trapezoidal in shape.4.4. The occlusal wall is longer and straight. The The occlusal wall is longer and straight. The

gingival wall is shorter than the occlusal due to gingival wall is shorter than the occlusal due to narrowing of tooth gingivally. This parallels the narrowing of tooth gingivally. This parallels the occlusal wall.occlusal wall.

5.5. The mesial and distal walls parallel the proximal The mesial and distal walls parallel the proximal line angle of the tooth and diverge facially meeting line angle of the tooth and diverge facially meeting the occlusal and gingival margins in sharp angles.the occlusal and gingival margins in sharp angles.

6.6. The axial wall is located in dentin and is 1mm deep The axial wall is located in dentin and is 1mm deep occlusally and 0.75mm deep gingivally.occlusally and 0.75mm deep gingivally.

Class 5 cavity preparation done using a no. 33Class 5 cavity preparation done using a no. 331/2 1/2

inverted cone burinverted cone bur

7.7. The entire preparation is done using a 331/2 The entire preparation is done using a 331/2 inverted cone bur.inverted cone bur.

8.8. A hoe or a monangle chisel may be used to A hoe or a monangle chisel may be used to established an acute axiogingival line angle. established an acute axiogingival line angle. This provides major retention form. Sharp line This provides major retention form. Sharp line and point angle also provide retention.and point angle also provide retention.

9.9. A slight cavosurface bevel is placed on all A slight cavosurface bevel is placed on all enamel margins using the wedelstaedt chisel.enamel margins using the wedelstaedt chisel.

General steps for General steps for direct gold restorationsdirect gold restorations1.1. Build up of the restorationBuild up of the restoration

1.1. Tie formationTie formation: This involves connecting two opposing : This involves connecting two opposing point angles or starting points filled with gold with a point angles or starting points filled with gold with a transverse bar of gold. This tie forms the foundation transverse bar of gold. This tie forms the foundation for any restoration in direct gold.for any restoration in direct gold.

2. 2. Banking of the walls Banking of the walls : Consist of converging : Consist of converging each wall from its floor or axial wall to cavo each wall from its floor or axial wall to cavo surface margin with a direct gold material. It surface margin with a direct gold material. It should be done simultaneously on the should be done simultaneously on the surrounding walls of the preparations.surrounding walls of the preparations.

3. 3. Shoulder formation Shoulder formation : This consist of connecting two : This consist of connecting two opposing walls with the direct gold material to completely opposing walls with the direct gold material to completely

fill the restorations.fill the restorations.

2.2. Paving of the restorationsPaving of the restorationsTo overfill the preparation every area of the To overfill the preparation every area of the

cavosurface margins should be indivisually covered cavosurface margins should be indivisually covered with excess cohesive gold foil. This is condensed with excess cohesive gold foil. This is condensed with a “foot” condenserwith a “foot” condenser

3.3. Surface hardening of the restorationSurface hardening of the restorationThe rectangular condenser is used with the highest The rectangular condenser is used with the highest

possible condensation pressure in all directions on possible condensation pressure in all directions on the surface of the restoration to strain harden the the surface of the restoration to strain harden the surface gold.surface gold.

4.4. BurnishingBurnishingThis is done with suitable burnisher moving from the This is done with suitable burnisher moving from the

gold to the tooth surface. This enhances the surface gold to the tooth surface. This enhances the surface hardening and also produces good marginal hardening and also produces good marginal adaptation of the gold.adaptation of the gold.

5.5. MarginationMarginationThis step uses gold knives to remove excess gold from This step uses gold knives to remove excess gold from

the gold surface to the tooth surface.the gold surface to the tooth surface.

6.6. BurnishingBurnishingIt helps to eliminate marginal discrepancies It helps to eliminate marginal discrepancies

and to strain harden the surface.and to strain harden the surface.

7.7. ContouringContouringThis step uses knives,files, or finishing burs This step uses knives,files, or finishing burs

to create proper occlusal anatomy. to create proper occlusal anatomy. Burnishing is done again after contouring.Burnishing is done again after contouring.

8.8. Finishing and polishingFinishing and polishingCan be done using tin oxide powder on soft Can be done using tin oxide powder on soft

bristle or rubber cups.bristle or rubber cups.

9.9. Final burnishing Final burnishing This is done after polishing to make surface of This is done after polishing to make surface of

restoration smooth and free from voids.restoration smooth and free from voids.

BIBLIOGRAPHYBIBLIOGRAPHY BaumBaum

CharbeanuCharbeanu

SikriSikri

MarzoukMarzouk

Ramya RaghuRamya Raghu