D2790 Dental Code: Crown – Full Cast Noble Metal
1. Introduction to D2790 Dental Code
The D2790 dental code refers to a full cast noble metal crown, a type of dental restoration that covers a damaged or decayed tooth entirely. This crown is fabricated from high-quality noble metals, such as gold, platinum, or palladium alloys, known for their durability, biocompatibility, and resistance to corrosion.
Unlike porcelain or zirconia crowns, noble metal crowns are highly malleable, allowing for precise marginal fit, reducing the risk of recurrent decay. They are often recommended for posterior teeth (molars and premolars) due to their strength and longevity.
This guide explores every aspect of the D2790 code, including its clinical applications, procedural steps, cost factors, and comparisons with other crown types.
2. Understanding Full Cast Noble Metal Crowns
A full cast noble metal crown is a single-piece restoration made entirely from noble metal alloys. These metals are classified as “noble” because of their resistance to oxidation and tarnishing.
Key Characteristics:
- Biocompatibility: Rarely causes allergic reactions.
- Durability: Can last 20+ years with proper care.
- Minimal Tooth Reduction: Requires less removal of natural tooth structure compared to porcelain-fused-to-metal (PFM) crowns.
- Superior Marginal Fit: Reduces plaque accumulation and secondary decay.
Common Noble Metal Alloys Used:
| Metal | Composition | Properties |
|---|---|---|
| Gold (Au) | 60-90% gold, with silver, copper, platinum | Highly corrosion-resistant, excellent longevity |
| Palladium (Pd) | Palladium-silver alloys | Strong, lightweight, cost-effective |
| Platinum (Pt) | Platinum-gold alloys | Extremely durable, hypoallergenic |
3. Indications for D2790 Crowns
Dentists recommend D2790 crowns in cases such as:
- Severe Tooth Decay: When a large portion of the tooth is damaged.
- Fractured Teeth: To restore structural integrity.
- After Root Canal Treatment: To protect the weakened tooth.
- Bruxism (Teeth Grinding): Noble metals withstand heavy occlusal forces.
- Allergic Reactions to Base Metals: Patients sensitive to nickel or other alloys.
4. Contraindications and Limitations
While noble metal crowns offer many benefits, they may not be suitable for:
- Anterior Teeth: Due to their metallic appearance.
- Patients Wanting Aesthetic Options: Prefer ceramic or zirconia crowns.
- High-Cost Concerns: More expensive than PFM or all-metal base crowns.
5. Step-by-Step Procedure for D2790 Crown Placement
- Diagnosis & Treatment Planning
- X-rays and impressions are taken.
- Tooth Preparation
- The tooth is reshaped to accommodate the crown.
- Impression & Temporary Crown
- A mold is sent to the lab; a temporary crown is placed.
- Fabrication (Lab Process)
- The crown is cast from noble metal alloy.
- Crown Cementation
- The final crown is bonded using dental cement.
(Insert image of crown preparation process here)
6. Comparing D2790 with Other Crown Codes
| Code | Crown Type | Material | Best For | Durability | Cost |
|---|---|---|---|---|---|
| D2790 | Full Cast Noble Metal | Gold/Palladium/Platinum | Molars, Bruxism | 20+ years | $$$ |
| D2740 | All-Ceramic | Zirconia, Emax | Anterior Teeth | 10-15 years | $$$ |
| D2750 | Porcelain-Fused-to-Metal (PFM) | Metal + Porcelain | Both Anterior & Posterior | 10-15 years | $$ |
| D2780 | Full Cast Base Metal | Nickel/Chromium | Budget Option | 10-15 years | $ |
7. Cost and Insurance Coverage
- Average Cost: 1,000−1,000−1,500 per crown.
- Insurance Coverage: Many plans cover 50% of the cost.
8. Patient Care and Maintenance
- Brush twice daily with non-abrasive toothpaste.
- Floss regularly to prevent gum disease.
- Avoid chewing hard objects (ice, hard candy).
9. Common Complications and Solutions
- Loose Crown: Re-cement or replace.
- Allergic Reaction (Rare): Switch to ceramic.
- Wear Over Time: Monitor and replace if needed.
10. FAQs About D2790 Crowns
Q: How long does a noble metal crown last?
A: 20+ years with proper care.
Q: Are gold crowns safe?
A: Yes, they are biocompatible and hypoallergenic.
Q: Can I get a noble metal crown on a front tooth?
A: Possible but not recommended due to aesthetics.
11. Conclusion
The D2790 dental code represents one of the most durable and long-lasting crown options in dentistry. Noble metal crowns are ideal for posterior teeth, offering superior strength, biocompatibility, and longevity. While they may not be the most aesthetic choice, their clinical benefits make them a top choice for patients needing reliable restorations.
12. Additional Resources
- American Dental Association (ADA) Crown Guidelines
- Journal of Prosthetic Dentistry – Noble Metal Research
