For a tooth with a large cavity, which restoration is best for gingival health?

Choosing the best restoration for a tooth with a large cavity in relation to gingival health requires considering both the material properties and the restoration design. When using gold onlays or porcelain-fused-to-metal (PFM) restorations, these materials are known for their durability, excellent fitting, and ability to maintain proper contours around the gingival margin.

Gold onlays and PFM restorations can be crafted with precision to ensure a proper seal at the margins, reducing the risk of microleakage, which can lead to secondary caries and exacerbate gingival issues. This tight adaptation to the tooth structure can promote better periodontal health by preventing plaque accumulation around the edges of the restoration. Furthermore, their smooth surface finish contributes to easier cleaning for the patient, subsequently diminishing the likelihood of gingival irritation and periodontal inflammation.

While other materials, such as composite resins, amalgam, and glass ionomer cement, may have their respective benefits, they may not always provide the optimal margin integrity and long-term performance needed in large cavity restorations. This makes gold onlays or PFM restorations a preferred option for ensuring better gingival health in the context of managing extensive decay.