Dentistry is such a rewarding profession because we literally have the ability to change peoples’ lives not only by doing a complete esthetic or reconstructive case, but even when we do a single crown on a patient. As a result of our work, patients have the ability to function better, enjoy their food more and look better when they smile.
We get excited by the look of the crown when it first goes in, but how does that porcelain fused to metal crown look one year, two years or five years down the line? Has the tissue reacted kindly, or is the gingival tissue red and puffy? Is there a dark line at the margin that the patient is now asking you about—wondering if they made the right decision? Is the fit as precise as we would like?
These are the challenges that general dentists experience repeatedly in their daily practice. Some of the metals we use in porcelain fused to metal crowns may cause a reaction in the tissue; maybe the fit, or the lack thereof, becomes a plaque trap, and the margins look dark almost immediately because of the darkened oxides of the metal. After getting a first crown, the patient may be wary of getting another—because of the poor experience and esthetics of these crowns that have been placed in the past.
As an evaluator for Clinical Research Associates (CRA), whose motto is, “Faster, Easier, and Better Dentistry,” I have learned to invest in any technology, or use any technique, that will make my dentistry fit the motto. When it comes to choosing metals in crown and bridge prosthetics, the metal that we grew up with, and primarily learned about in dental school, was gold. There are so many advantages to gold. First of all, gold is very kind to the gingival tissues. There is no oxidation, so it will not lead to black lines at the gingival margins. Gold is capable of providing excellent, warm, natural shades under applications of porcelain, and also can be used to deliver the whitest bleach shades possible without the opacious dull look of traditional metal alloys.
So why have we gone away from gold under our porcelain fused to metal crowns? Because of the high cost of gold. In addition, very few laboratories now choose to use gold, and therefore it is hard for the general dentist to find.
Well, now you can go for the gold again under your PFMs. Captek is an 88% gold alloy, which through a unique fabrication system can now put the gold right back where it belongs, underneath the porcelain in your patients’ crowns.
The advantages of using Captek are many; there is no dental material available that is more biocompatible than Captek. Studies by the Forsyth Dental Center and the University of Minnesota have shown that Captek-restored teeth have 71 to 91 percent less bacterial plaque than teeth with no restorations. The tissue health is superb. IADR research presented in 1995 showed the Captek fit is superior to all other restorations, with the laboratory being able to get the margin to approximately 15 microns. This is due to the fact that there is virtually no expansion or contraction, as there is no casting of the metal.
Because it is a high gold alloy, Captek can impart a natural hue to porcelain veneered crowns and bridges. This makes Captek a uniquely esthetic choice for crowns and bridges. Boston University research showed that the sheer bond strength of Captek is equal to or greater than that of all other alloys used for traditional PFMs. Captek can be adapted to any type of margin, giving the clinician great flexibility, depending upon the clinical situation. It can easily be used for single crowns, implants, and bridges with pontic spans up to 15 mm, both anteriorly and posteriorly.
Another huge advantage is that you can apply pressed ceramic to Captek. This provides increased porcelain strength, as well as a nearly all-ceramic esthetic result. Pressed ceramic with Captek restorations have another distinct advantage over full pressed ceramic crowns—a conventional crown and bridge cement can be used instead of having to use demanding resin bonding procedures.
I personally use Trident Dental Laboratories for all of my Captek crowns. When the makers of Captek tell me they have visited Trident Dental Labs and are impressed with the level of Captek crowns being produced, it says a lot to me.
With all of the advantages, and the reasonable price of the Captek crown from the dental laboratories (within a few dollars of what you are probably paying now for your porcelain fused to metal crowns), why wouldn’t you use Captek for every crown? It is certainly my choice for traditional crown and bridge procedures, and it fits the motto: it’s faster because it can be adapted to any type of margin, it’s easier because I can use any crown and bridge cement, and it’s better because the patient will have a more esthetic, longer-lasting result that is kind to the gingiva.
Captek is what I call “back to the future” dentistry. We all started with gold, and after having tried so many metals, I am back to using gold. Use Captek for your crown and bridge procedures—your patients will be happier with the results, and so will you.