Pt complain from pain in 45 which had gold onlay. The pain could be due to.. High thermal conductivity of gold. Referred Pain. Periodontal Problems. Fractured Tooth. Marginal Leakage. Occlusal Interference. Pulpitis

Pt complain from pain in 45 which had gold onlay. The pain could be due to:

• a- Chemicals from cement.
• b- High thermal conductivity of gold.***
• c- Related to periodontal ligament.
• d- Cracked tooth or fractured surface.

Disadvantages of gold restoration:

Esthetics – cost – time consuming – difficulty of technique – the need to use cement (the weakest point in the cast gold restoration) – gold has high thermal conductivity.

Possible pains due to gold studs:

There are several potential reasons for the pain experienced in tooth number 45 (mandibular second premolar) with a gold onlay. Here are some possible causes:

- Occlusal Interference:

If the gold onlay is not properly aligned with the opposing teeth or if there is an issue with the patient's bite, it can create excessive pressure on the tooth during biting and chewing, leading to pain.

- Pulpitis:

The pulp of the tooth may become inflamed or infected due to deep decay, trauma, or extensive tooth preparation for the onlay. This can result in tooth sensitivity or a persistent toothache.

- Marginal Leakage:

If there is inadequate sealing or bonding between the gold onlay and the tooth structure, bacteria and oral fluids can seep in around the edges of the restoration. This can lead to irritation of the underlying tooth structure and cause pain.

- Fractured Tooth:

It's possible that the tooth may have a fracture, either visible or hidden within the tooth structure. Fractures can occur due to excessive biting forces or trauma, and they can cause severe pain, especially when chewing.

- Periodontal Problems:

Pain in the area could be related to gum disease or periodontal issues affecting the tooth. If there is gum inflammation, recession, or infection around tooth number 45, it can cause discomfort and sensitivity.

- Referred Pain:

Sometimes, pain originating from a different tooth or area of the mouth can be perceived as coming from tooth number 45. This is known as referred pain and can make it challenging to identify the exact source of the discomfort.

It's important for the patient to visit a dentist to determine the cause of the pain accurately. The dentist will conduct a thorough examination, possibly including X-rays or other diagnostic tests, to diagnose the underlying problem and recommend appropriate treatment.