 |
|||||||
|
|||||||
|
 |
|
 |
Cast gold study club development in the Pacific Northwest has been an extension of the strong gold foil study club activity in this area. It has been a strong influencing factor over the years in the promotion and the development of a high level of refinement not only in the quality of restorative dentistry but of cavity design, esthetics and finish. A brief review of its short history may be in order for the stimulation and inspiration of old and new members alike. Dr. Richard V. Tucker, who practices in Ferndale, Washington; came under the influence of Dr. George A. Ellsperman from Bellingham, Washington. Dr. Ellsperman was one of the twelve original members of the Seattle Dental Study Club. He later served as the founding mentor of the Vancouver Ferrier Gold Foil Study Club of which Dr. Tucker became a member. Dr. Gerald D. Stibbs became the mentor after Dr. Ellsperman retired from active practice. Under the influence and guidance of these two superb clinicians, Dr. Tucker began experimenting with conservative cast gold restorations, adapting many of the same gold foil principles of fit, esthetics, finish and polish. With the advent of the high speed handpiece, extracoronal as well as intracoronal preparations became easier to prepare and quadrant restorative dentistry became more routine. This acceleration and ease in preparing cavity preparations with highspeed led Dr. Tucker to use the bur more in preparing the bulk of the cavity preparation as well as using it to plane and smooth most of the walls and floors. In the past most of the preparation had been cut with hand instruments. With the advent of off-angle chisels and modified gingival margin trimmers the number of hand instruments needed to refine the preparation was streamlined to a minimum. The conservative nature of gold foil preparations was adapted to meet the criteria for various cast gold preparations and with highspeed new types of cavity designs and preparations were developed. It also allowed for the two disciplines to be used in conjunction with each other for the conservation of tooth structure. The use of the egg-shaped twelve-bladed bur further helped to revolutionize and simplify conservative cavity preparations. The quest for the perfect casting from the laboratory led to very precisely fitting castings but the margins were never perfect. By adapting some of the gold foil finishing procedures to the cemented castings, gold foil like margins could be more nearly achieved. Dr. Tucker through slides and table clinics graciously shared his procedures and techniques with his fellow dentists. As a member of the Frank Allen Restorative Seminar, he was asked to become its mentor in 1970. He served in that capacity until 1976. In the same year, he was asked to mentor a group in Vancouver, B.C. and Redmond, Washington in conservative cast restorations. This led to the formation of another group in Seattle, Washington in 1978 and another in Vancouver B.C. in 1981. The number of clubs has now grown to more than thirty-five ranging from Arizona, California, Oregon, Washington, Nevada, Indiana, Nebraska, New Jersey, New Mexico, Canada and Europe. The Academy of Richard V. Tucker Cast Gold Study Clubs came together in Seattle, Washington for the first time under the sponsorship of the Redmond Club in 1986. Each year since that time, a different club has hosted the annual meeting. Each meeting, in addition to the social aspect, has a clinical session where operators are either seating castings or placing gold foils and lectures on various subjects dealing with gold. An outstanding clinician who has made significant contributions to restorative dentistry is asked to be a George Ellsperman lecturer each year. The primary purpose of our study clubs is the pursuit and promotion of excellence in the practice of conservative dentistry through the development of proficiency in cast gold and gold foil techniques. Each operator should work to develop his or her talents to the fullest. This is a slow and arduous task, but gratifying and rewarding. Some of the clubs have accomplished this purpose by working on gold foil techniques and the applications that blend the two disciplines. Some members also have operated at national meeting as well as given essays and table clinics at local, state and national meetings. What Is A Study Club? (Back to Top of Page) An operating study club consists of a group of generally not less than 8 or more than 12 individuals, who are interested in learning, perfecting and practicing a particular dental technique, such as cast or direct gold. The technique is learned from a mentor well versed and skilled in the technique and is usually chosen either by the group or by the head mentor of the academy. The individuals work on patients, perfecting their clinical skills for a 3 or 4 hour block of time. The object of going to a study club is to see how well each individual can perform a particular operation rather than seeing how fast or how many operations can be performed. Following each operating session, there is a social time and a meal, where critiques of each operation is given by the mentor and/or reporter, and the business of the club is conducted. By learning to perfect the step-by-step technique of a variety of procedures in study club, these procedures can be done in the office economically as the operator gains confidence. Benefits Of A Study Club (Back to Top of Page) By learning to complete each step of an operation and doing them to the best of their ability, little time is wasted by the operator. This allows the outcome of the procedure to become very predictable and the individual to become more productive. These procedures can now be offered to patients as a treatment option and become an integral part of every day practice. The satisfaction of doing a procedure well is not only rewarding to the individual but creates a better patient-dentist relationship and trust. The results and predictability of a step-by-step method reduces office and individual stress as well as eases the training of ancillary personnel. The individual also has an opportunity to compare the results, using the materials and techniques of the mentor versus what they use in the office. Referral of patients by like-minded dentists, who have seen one operate at a national meeting, is an added bonus of study club efforts. Starting A Study Club (Back to Top of Page) 1. Get together 8 to 12 individuals who are interested in learning and perfecting a technique such as cast gold. 2. Get a mentor well versed and skilled in the technique to be practiced, perfected and learned. 3. Find a facility where, if possible, that all the participants can operate at the same time; such as a school, university, military facility or large office. (If such a facility is not available, then operators can work in several shifts.) 4. Elect a president and secretary for the club. 5. Expenses are calculated for mentors honorarium, hotel, airfare, rental car, etc., operating facility, social time (meals and libations), and are divided by the number of members. 6. A name of the group is chosen by the members. 7. A checking account is opened and dues are collected from each member by the secretary once or twice a year. 8. A clinical session should be planned for a 4 hour block of time with social time and meal following. Critique by a reporter and mentor are given at this time as well as conducting the clubs' business. 9. The president conducts the meeting and the secretary records the clubs' business and a synopsis of the days operations. Each member receives a copy of the report of the previous meeting which includes: meeting dates, place, operations, critiques, etc. 10. Monthly 8 or 9 sessions a year should be planned, if possible, starting in September and ending in May. Advantages Of Using Gold To Restore Posterior Teeth (Back to Top of Page) 1. Gold will not oxidize and discolor the teeth. 2. Fragile areas of tooth structure remaining can be protected by covering them with a thin layer of gold. Gold will not fracture even when it is thin. 3. The cast gold restoration will not fracture in the isthmus or other areas. 4. The margins at the junction of the tooth and gold are nearly imperceptible if handled properly, and will not be so likely to harbor plaque, and consistently should contribute to better tissue health. 5. Contact areas can be placed and polished for ease in the use of dental floss, thus promoting better tissue health. 6. Gold can be polished and finished to a higher degree than other materials. 7. Gold castings such as 7/8 modified full crowns or conventional full crowns can be used to "bind the tooth together" and prevent tooth fracture, or relieve sensitivity from incipient tooth fractures. 8. The normal tooth anatomy can be more nearly reproduced with a casting. 9. Cast gold wears more nearly the same as tooth structure and does not produce sub-marginal surface. Precise fitting castings will support the marginal enamel rods which prevents chipping and fracturing at the cavo-surface margins and minimizes the possibility of marginal leakage and bacterial invasion. 10. Gold castings have a favorable coefficient of expansion with tooth structure. 11. Well placed gold casting will last much longer than other filling materials used today. 12. The sensory acceptance of gold by the tongue and the feel during mastication is enhanced by the smoothness and anatomical replication of the missing tooth structure. Where Can I Go To Learn More About Dr. R.V. Tucker's techniques In Restoring Posterior Teeth With Cast Gold? (Back to Top of Page) Educational materials, available hands-on participating courses, videos, and other additional information is available through the Education Committee of the Academy of R.V. Tucker Study Clubs. Additional information is also available in the Member Center of our website. |