An audit of the quality of base metal cast restorations provided within the restorative department of a UK dental institute

Abstract

Background Gold alloy has long been used in dentistry for the fabrication of cast restorations due to its material and clinical properties and known excellent longevity over long-term follow-up. The cost of gold has increased dramatically in recent years (by 450% in the past ten years). The use of base metal alloys as an alternative would lead to a considerable cost saving: a cobalt chromium alloy is around 98% cheaper than gold alloy at the time of writing. NHS regulations state which alloys are permissible for use in cast restorations in dentistry, and certain 'non-precious gold' alloys should not be used.Materials and methods A prospective audit was carried out in our unit into the standard of cast restorations in cobalt-chromium alloy. The standard set before the audit was established by a prior audit of gold alloy restorations with measures of clinical and technical factors.Results Base-metal alloy restorations were considerably cheaper; but were of a poorer clinical standard than gold-alloy and required more frequent adjustment and remake (17% compared to 5%).