Thank you to Dr. Glynn for his kind comments about my column on tooth-colored inlays and onlays. I agree with his observations about gold alloy onlays. They serve well for several decades in my experience. However, in the United States, few patients will accept the appearance of gold alloy in their mouths. In my own practice, I find that the majority of gold alloy restorations are placed on my dentist patients. Obviously, they understand the significant longevity potential of cast gold-alloy restorations.
Cast gold restorations, especially onlays and partial and full crowns, have the best longevity characteristics of all restorations for posterior teeth. However, public demand is continuing to popularize tooth-colored direct and indirect restorations, and advancements in tooth preparations, cements and ceramics are making the indirect tooth-colored restorations acceptable for many situations.
I advise practitioners to inform patients about the longevity characteristics of metal versus tooth-colored restorations as they make their choices about which restorations to have placed in their mouths. Unfortunately, most of the time, esthetic considerations outweigh longevity.
