Alloys for PFM

[leoele]

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Alright, could a few people humor me and post what type of alloy you use at your school (or practice if you are done) for a PFM coping.

 

[browncrack]

They all go to outside labs. Depending on allergies, either high noble or base metal. The lab returns a flier with specific composition that goes into the chart.

 

[mike3kgt]

Here's a chart taken from the Rosenstiel book. Any one of these alloys can be used for PFMs.

Most of the time you don't know what alloy the lab is using, specifically, however, you can request certain categories... i.e. 1. High gold, high noble alloy (Jelenko O = $$$$), 2. Moderate gold, high noble alloy (Olympia = $$$), 3. Silver-Palladium type Noble alloy (Superstar = $$), 4. Base metal (Rexillium = $).

Most practices and dental schools use category 3. In my own mouth, category 1 or 2, depending on the restoration needs. Stay away from type 4 if you can... but it works in certain situations.

See the following chart:

 

[OceanDMD]

Here's a chart taken from the Rosenstiel book. Any one of these alloys can be used for PFMs.

Most of the time you don't know what alloy the lab is using, specifically, however, you can request certain categories... i.e. 1. High gold, high noble alloy (Jelenko O = $$$$), 2. Moderate gold, high noble alloy (Olympia = $$$), 3. Silver-Palladium type Noble alloy (Superstar = $$), 4. Base metal (Rexillium = $).

Most practices and dental schools use category 3. In my own mouth, category 1 or 2, depending on the restoration needs. Stay away from type 4 if you can... but it works in certain situations.

See the following chart:

Whats wrong with nobel? Why only high noble in your mouth? I find more failures with high noble than noble with respect to porcelain delamination. As far as any bridgework I would definitely stay away from high noble. More flexure means more failures. Lab bills currently will be 30-40% higher using high nobel as well.

 

[leoele]

They all go to outside labs. Depending on allergies, either high noble or base metal. The lab returns a flier with specific composition that goes into the chart.

I was under the impression that the use of base metals with respect to PFM treatments was no longer common practice. Really, that is the purpose of this post. I am trying to get a feel for how common their usage actually is.

 

[mike3kgt]

Whats wrong with nobel? Why only high noble in your mouth? I find more failures with high noble than noble with respect to porcelain delamination. As far as any bridgework I would definitely stay away from high noble. More flexure means more failures. Lab bills currently will be 30-40% higher using high nobel as well.

Nothing wrong with noble alloys for long-span needs. I don't need that in my mouth nor plan on it.

I use noble alloys many times for long span FPDs or hybrid frameworks. Again, no need in my mouth. If I needed one of these types of restorations, I would be in that category. A high gold content alloy could work in these situations, but flexure is a concern. For 3 unit FPDs or single units, gold-palladium is still my #1 choice.

With some silver or copper containing metals, I would be slightly more concerned with porcelain greening or tissue sensitivity reactions respectively.

Now in regards to the OPs comments, many many clinicians still use base-metal PFM crowns. Porcelain adherence to base metal alloys is quite significant due to a thicker oxide layer, however tissue reactions can be significant as well. Labs also don't really want to work with these metals because they are much more difficult to cast. Really the reason most use base metal alloy PFM restorations is due to lower cost of the alloy.

I see a lot of clinicians going with eMax or full zirconia type all ceramic restorations. These are excellent alternatives to base-metal restorations as alloy cost is zero, marginal integrity is adequate, and the restorations are esthetic.