DIRECT FILLING

GOLD

Submitted By:
Deepika Bali
 Direct golds are those gold restorative materials
that are manufactured for directly compacting them
in to the prepared cavities.

 This noble metal is a superior restorative material for

small defects and lesions in teeth.
Pure gold has been a metal of special intrinsic and practical value.
In its pure form, gold has unusual ability to cohere to itself at
room temperature.
Gold is quite soft and in a compressible form, increments can be
welded by pressure in to solid metal mass inside a prepared
tooth cavity. The metallic bonding between overlapped
increments produces the direct gold restoration.
It requires care and cleanliness in handling the metal and skill
necessary in use , cohesive gold has acquired a reputation as a
material that embodies perfection in hands of skillful, well
trained operative dentist.
 Types of Direct Filling Gold
1. Gold foil

A. Sheets
B. Pellets (hand rolled & preformed)
C. Cylinders
D. Corrugated foil
E. Platinized foil
F. Laminated foil
2. Electrolytic precipitated gold
A. Mat gold
B. Mat foil
C. Gold calcium alloy

2. Powdered gold
A. Goldent
 Gold Foil
Gold foil is also called fibrous gold .It is available as
sheets , pellets , cylinders , ropes and precondensed
laminates of varying thickness.

A. Gold foil sheets: these are manufactured by beating

or rolling pure gold ingots into thin sheets. Gold foil
is cut into 4x4” sheets. These sheets are seperated
by thin paper and bound in books containing 1/10 or
1/20 ounces of gold. No.4 gold foil is the standard
size and weighs 4 grains. No. 3 gold foil weighs 3
grains. No. 2 gold foil weighs 2grains.since these
sheets are too large for restorative purposes, the
are rolled into pellets or cylinders before insertion
into cavity preparation.
B. Gold foil pellets: these may be hand rolled or
commercially produced from a no. 4 gold foil
sheets. Small sections of the gold foil sheets
(1/32”, 1/64”, 1/128”) are cut and rolled into
pellet form.

C. Gold foil cylinders: these may also be hand rolled

or preformed. Usually larger segments of sheet
(1/2”,1/4’, 1/8”) are cut and rolled into cylinders.

D. Corrugated gold foil: these are manufactured by

placing thin sheets of paper in between the gold
foil sheets and igniting them . The paper burns
and gets charred while the gold foil becomes
corrugated .
E. Platinized gold foil: this is a sandwich of gold and
platinum with the platinum content being 15%. It
may be manufacture in one of the following ways:

 One sheet of pure platinum foil may be sandwich

between 2 sheets of gold. These are then hammered
to form a platinized gold foil.
 Layers of platinum of gold are rolled over together to
bring about their fusion following which they are
beaten to achieve desired thickness .

Addition of platinum increases the strength and wear

resistance of the restoration. Platinized gold foil may be
used for areas of stress concentration like incisal edges
and cusp tips.
F. Laminated gold foil: when gold foil is beaten from an
ingot, its crystals are elongated in a specific
direction. A combination of two or three foils with
crystals running in different direction is called a
laminated gold foil. Since the crystals run in all
direction, laminated gold foil are stronger and can
be used in stress-bearing areas like cusp tips and
incisal edges.
 Electrolytic precipitated gold
This is a crystalline gold powder formed by
electrolytic precipitation. The powder is made
into different shapes by sintering at an elevated
temperature well below the melting point of gold.

A. Mat gold : this is a crystalline electrolytically

precipitated gold that is formed into strips. This form is
easy to use for building the internal bulk of the
restoration because of ease of compaction. But mat gold is
loosely packed so it shows numerous voids between the
particles. Hence it is not recommended for the external
surface of the restoration as it become pitted.
B. Mat foil : this consists of sandwich of
electrolytically precipitated gold powder
between two sheets of No. 3 gold foil which is
sintered and cut into strips. This purpose of
sandwiching mat gold between foil sheets is to
eliminated the need to veneer the restoration
the layer of foil.

C. Gold calcium alloy : this the another form of

electrolytically precipitated which is alloyed
with 0.1% calcium. It is commercially available
as Electralloy RV. The addition of calcium
produces a stronger restoration by dispersion
strengthening . This is sintered so as to make
the gold into strip form
 Powdered gold
 Powdered gold is made by a combination of chemical
precipitation and atomization with an average particle
size of 15 m.
 Since powders are difficult to manipulate the
particles are mixed together in wax and cut in to
pieces and wrapped in gold foils as pellets.
 This is available as Goldent or Williams E-Z Gold.
 Properties of direct filling

gold
Pure gold is soft, malleable and ductile and does not
oxidize under normal atmospheric conditions.

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

 Gold fusses at 10630 c and boils at 22000 c.

 Density of pure gold is 19 – 19.3g/cm3 but this is reduce

by voids incorporated during restoration to14 -15g/cm3

 The brinnell hardness no. for gold is 25 this makes it

very soft. However during compaction the hardness
increases 258-82 making it a strong material.
 The coefficient of thermal expansion of gold is 14.4 x
10-6/ 0C which is close to that of tooth structure(11.4 x
10-6/ 0C)

 Even small amount of impurities can affect the

mechanical properties of gold. Very small amount of
lead, bismuth, mercury adversely affect the
properties of gold. However, minute amount of calcium,
palladium, and platinum can improve the properties of
gold.

 It can be cold welded at room temperature.

 Gold exhibits excellent marginal integrity and

biocompatibility with the oral tissues.
 Advantages of direct gold
1. When properly placed, direct gold is the most durable
restorative material.
2. As pure gold is a noble metal, it does not undergo tarnish or
corrosion in the oral cavity.
3. They are insoluble in the oral fluids and exhibit thermal
expansion similar to that of dentin.
4. When proper case selection is done and the cavity preparation
is kept ideal, it is atraumatic to the dental pulp and supporting
structures.
5. Direct gold exhibits good adaptation to the cavity walls. Being
ductile it can be burnished against the cavity margins to
create excellent marginal integrity.
6. The surface of direct gold can be polished well and the
smoothness will last indefinitely .
7. The density and hardness of compacted gold provide adequate
compressive strength.
 Disadvantages of direct gold
1. The yellow colour of pure gold is not esthetically
acceptable to most of the patients.
2. The manipulation of gold is very exacting and
difficult to master.
3. It is time consuming.
4. Expensive material.
5. Thermal conductivity of gold is high. So pulp
protection is necessary under gold restoration.
 Indications
1. Class 1 Cavity : Direct gold is indicated for small carious
lesions in pits and fissures of posterior teeth and lingual
surfaces of anterior teeth.
2. Class 2 cavity : Direct gold is indicated for minimal proximal
caries in posterior teeth especially premolars when marginal
ridges are not subjected to heavy occlusal stresses.
3. Class 3 Cavity : Can be used for small carious defects in
anterior teeth when the defect is only on the proximal
surface and esthetics will not be affected.
4. Class 5 Cavity : For minimal caries in the Cervical one third of
teeth direct gold can be used. Also for small abrasion, erosion
or abfraction defects on the facial surfaces of teeth.
5. Class 6 Cavity : For restoration involving incisal edges or cusp
tips direct gold can be used, provided there is no heavy
occlusal stress.
6. Defective Crown margin : It can be repaired with direct gold.
 Contraindications
1. Young Patients : Because of presence of large pulp chambers it
is contraindicated as the malleting forces of direct gold may
not be tolerated by the pulp.
2. Poor periodontal status : In periodontally weakened teeth,
direct gold is not employed because of questionable prognosis.
3. Heavy occlusal stresses : For moderate to large carious
defects direct gold is not used as it can not withstand heavy
occlusal forces.
4. Economics : It is not indicated when cost is the limiting factor.
5. Handicapped Patients : It is contraindicated as long
appointments are necessary.
6. Esthetics : When esthetic is the main concern it is not
recommended.
7. Access and isolation difficulties.
Manipulation of direct filling gold

There are two processes involved;

 Degassing

 compaction
 Degassing [annealing]
 Degassing is the process of heating
direct gold materials to remove the
surface contaminants.
 It can be achieved by
 Heating the gold foil over pure ethanol flame.
 Heating in a mica tray mounted over an alcohol

lamp
 Heating in a electric annealer.
1. Heating over an open alcohol flame:
In this method each piece of direct gold is held in the middle
zone of an alcohol flame for 3-5 sec before inserting into
the cavity preparation.
2. Heating in a mica tray over the alcohol flame:
This is a bulk method where several gold pellets are
degassed in a mica tray held over the alcohol flame. This
method tales less time but care should be taken to prevent
the gold pieces from sticking to each other.

3. Heating in an electric annealer :

In this the desired amount of gold is placed in the
compartments of the annealer and the lid is closed. The gold
is heated to 850 0 F for ten minutes and then allowed to cool
before it is placed in the cavity.
 Hazards during
degassing.
1. Overheating – If the gold is heated for prolonged
periods of time or to high temperatures, excessive
sintering and contamination from the tray,
instrument or flame can occur. This results in
recrystallization and grain growth, decrease
plasticity of the material and improper compaction
of the gold.

2. Underheating – If the gold is not heated adequately

it results in incomplete removal of surface
impurities. This leads to poor cohesion between the
gold pieces on condensation causing pitting and
porosity in the final restoration.
 Certain Principles to be
followed for compaction of
1.
direct gold
The force of condensation should be at 450 to the cavity walls
and floors. This produces maximum adaptation of the gold into
all details of cavity preparation.
2. The force of condensation must be at 900 to previously
condensed gold to prevent displacement of the already
condensed pieces of gold.
3. Whenever condensing a piece of direct 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 movements, the
condenser should overlap at least half of the previously
condensed area. This process is called “stepping”. This ensures
maximum adaptations of the gold to the cavity walls and also
cold welds. Each increment of gold thus reducing the voids.
4. Minimally sized increments of gold should be used.
Modes of condensation:
1. Hand instrument condensation- The energy
produced by this method is not sufficient to fulfill
the objective of condensation. However, it can be
used only as a first step in a two step condensation
process, simply to effect the initial confinement of
the material within the cavity preparation.
2. Pneumatic condensation- This involves the use of
vibrating condensers energized by compressed air.
3. Electronic condensation- This is the most efficient
and controlled way of condensing materials the
vibrating condenser heads can have an intensity or
amplitude from 2 oz. to 15 lbs. and a frequency of
360 to 3600 cycles per minute.
4. Hand condenser and mallet- It requires a trained
assistant to apply the condensation energy with a
mallet. This in turn must be in coordination with
locating the hand condensers by the operator to
the inside of the cavity preparation.
 General principles of cavity
preparations for direct gold
1.
restorations
The outline form : Should include all structural defects and
margins must be placed on sound tooth structure. The outline
should be smooth and designed to be esthetically pleasing.
2. Resistance form : Is achieved by creating flat pulpal floors
perpendicular to occlusal forces. The walls must be smooth
and flat. Enamel walls must be supported by sound dentin the
cavity width must be minimal while providing adequate
convenience form.
3. Retention form : Is achieved by parallel or slight occlusal
convergence of the facial and lingual walls. The depth of the
cavity should be 0.5 mm into dentin. The presence of sharp
internal line angles resist the movement of the restorations.
4. Convenience Form : Requires suitable access and a dry field.
The width of the cavity should be minimal. Sharp internal line
and point angles in dentin serve as convenient “starting” points
for compaction of direct gold.
 Class 1:Cavity preparations for direct
gold restorations
 The outline form is kept as small as possible while
providing convenience for instrumentation and
restoration.
 It is extended slightly beyond the lesion and it may be a
simple circular design, oblong, or triangular for a pit.
 The preparation is done with a no. 330 bur.
 The pulpal depth is .5mm in to dentin.
 The walls are extended minimally.
 Retentive undercuts are placed in dentin using a no. 331/2
Bur at a slow speed or using angle formers.
 Occlusal cavosurface margin is slightly beveled not more
than 0.2mm in width using a small finishing bur or a flame
shaped white stone. This allows a 40-45 degree metal
margin that can be burnished well against the tooth.
 Outline form for a class 1 pit cavity in a
mandibular premolar
 Class 2:Cavity preparation
1. The preparation is done with a no. 330 bur(pear shaped). The
outline includes entire defect and should be in the form of
straight lines and definite curves.
2. The proximal box is also prepared same as that of amalgam cavity
preparation except it is more conservative.
3. All walls of the proximal box are extended minimally into the
respective embrasures.
4. The cavity width is kept very narrow not exceeding 1/5 the
intercuspal distance.
5. Facial and lingual walls of the proximal box should only extend into
the contact area.
6. Breaking the contact is not necessary.
7. Gingival margins should just clear the contact area and not extend
subgingivally.
8. Cavosurface margins are beveled at 45 degree to the enamel walls.
9. All line angles except axiopulpal line angle are kept very sharp.
10. A reverse bevel is placed on the gingival floor towards the axial
wall.
Gingival floor showing reverse bevel
 Class 3:Cavity
preparations
FERRIER 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.33 1/2
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 1/3 rd
to meet the incisal angle.
The incisal margin extends just incisal to the contact area and
meets the facial and lingual walls in a smooth curve.

The axial wall is located 0.5mm into dentin. To provide enough

resistance form, the internal aspect of the preparation are
precisely instrumented .

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

Finally the wedlestaedt chisel is used to bevel the cavo surface

margins. This creates maximum convenience form, removes any
unsupported enamel and allows esthetic blending of the gold
restorations.
 Class 5 : Cavity preparation
1. Proper isolation is necessary.
2. The no. 212 clamp is modified before placement to
allow proper access and isolation of the class 5
lesion.
3. It trapezoidal in shape.
4. The occlusal wall is longer and straight. The gingival
wall is shorter than the occlusal due to narrowing of
tooth gingivally. This parallels the occlusal wall.
5. 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.
6. The axial wall is located in dentin and is 1mm deep
occlusally and 0.75mm deep gingivally.
Class 5 cavity preparation done using a no. 331/2 inverted cone
bur
7. The entire preparation is done using a 331/2
inverted cone bur.

8. A hoe or a monangle chisel may be used to

established an acute axiogingival line angle. This
provides major retention form. Sharp line and point
angle also provide retention.

9. A slight cavosurface bevel is placed on all enamel

margins using the wedelstaedt chisel.
 General steps for direct gold
restorations
1. Build up of the restoration
1. 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.
2. Banking of the walls : Consist of converging each
wall from its floor or axial wall to cavo surface
margin with a direct gold material. It should be
done simultaneously on the surrounding walls of
the preparations.
3. Shoulder formation : This consist of connecting two opposing
walls with the direct gold material to completely fill the
restorations.
2. Paving of the restorations
To overfill the preparation every area of the cavosurface
margins should be indivisually covered with excess
cohesive gold foil. This is condensed with a “foot”
condenser
3. Surface hardening of the restoration
The rectangular condenser is used with the highest possible
condensation pressure in all directions on the surface
of the restoration to strain harden the surface gold.
4. Burnishing
This is done with suitable burnisher moving from the gold
to the tooth surface. This enhances the surface
hardening and also produces good marginal adaptation
of the gold.
5. Margination
This step uses gold knives to remove excess gold from the
gold surface to the tooth surface.
6. Burnishing
It helps to eliminate marginal discrepancies and
to strain harden the surface.
7. Contouring
This step uses knives,files, or finishing burs to
create proper occlusal anatomy. Burnishing is
done again after contouring.
8. Finishing and polishing
Can be done using tin oxide powder on soft bristle
or rubber cups.
9. Final burnishing
This is done after polishing to make surface of
restoration smooth and free from voids.
 BIBLIOGRAPHY
 Baum

 Charbeanu

 Sikri

 Marzouk

 Ramya Raghu