Prosthodontics & Occlusion · single question

A patient with bruxism has a fractured mandibular molar with minimal remaining tooth structure. Which crown material is BEST suited for this clinical situation?

  1. Porcelain-fused-to-metal (PFM)
  2. All-ceramic (porcelain)
  3. Full gold (type III or IV gold alloy)
  4. Zirconia
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Correct answer: C. Full gold (type III or IV gold alloy)

For a bruxism patient with a fractured mandibular molar and minimal remaining tooth structure, full gold (cast metal) crowns are the most appropriate choice because: (1) Gold has excellent fracture resistance and toughness; (2) it requires minimal tooth reduction, preserving remaining structure; (3) gold has the closest wear characteristics to natural enamel, protecting opposing teeth; (4) it has excellent marginal adaptation. All-ceramic crowns (porcelain) are brittle and can fracture under bruxism forces. PFM crowns can chip and may wear opposing teeth. Zirconia is strong but requires more tooth reduction.

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