Sometimes, a tooth is treatment planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would compromise the structural integrity of the restored tooth by possibly undermining the remaining tooth structure or providing substandard opposition to occlusal (i.e. biting) forces.
In such situations, an indirect gold restoration may be indicated.
When gold is used, the tooth-to-restoration margin may be finished and polished to such a super-fine line of contact that recurrent decay will be all but impossible. It is for this reason that some dentists recommend gold as the restorative material of choice for pretty much any and all restorations.
While these restorations might be ten times the price of direct restorations, the superiority of gold as a restoration in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity and many other aspects of restorative quality offers an excellent alternative to the direct restoration. For this reason, some patients request gold restorations so they can benefit from its wide range of advantages even when an amalgam or composite will suffice. The only true disadvantage of gold is the higher cost, which is offset by the quality afforded to those who can afford it.