Invisible Class III gold foil restorations

Abstract

The cosmetic appearance of fillings placed in the anterior teeth is usually of greater importance to most patients than the permanency of the restorations. This requirement challenges the dentist who desires to provide his patients with the most permanent, as well as the most esthetic, restoration. Inasmuch as many young people have small carious regions in the proximal surfaces of the maxillary anterior teeth, this article will describe the operative procedures entailed. A local anesthetic should be adminis­ tered, a rubber dam placed over a suffi­ cient number of teeth and a separator judiciously applied so that the smallest cavity possible can be made either lingually or labially. Care must be exer­ cised not to undermine the incisal enamel or destroy the enamel which comes into contact with the proximating tooth. After the dentin has been insulated and the enamel walls planed, the separator can be removed and a silicate cement fill­ ing placed in the cavity. These cavities should be refilled as many times as is necessary, using care not to extend the cavity any further than the disintegration of the cement or carious region requires, until it is deemed advisable to insert a more permanent filling. Gold foil unquestionably is one of the finest filling materials in the hands of a skilled operator when used in properly selected instances. Because gold foil calks the cavity, it should not be compared to the gold or porcelain inlay which is sealed in place with cement. The distal surface of any cuspid is ideal for the placement of a gold foil filling because in most instances the completed filling is not visible from the labial aspect. Often gold foil restorations can be in­ serted in the proximal surfaces of maxil­ lary teeth so as to be invisible to the lay observer. The position of the proximal tooth as well as the location and size of the cavity may be a determining factor in governing the choice of filling mate­ rial to be used. All too frequently the outline of the Glass III cavity is made to conform to instrumentation for the sake of easy access and a definite opera­ tive procedure, instead of making instru­ ments and cavity outline conform to the