Dental ADA Code for Full Gold Crown

When it comes to restorative dentistry, full gold crowns remain one of the most durable and reliable options for tooth restoration. The American Dental Association (ADA) categorizes this procedure under the code D2790, which refers to a cast full metal crown primarily composed of high-noble or noble alloys.

Gold crowns have been used in dentistry for over a century due to their exceptional biocompatibility, strength, and minimal wear on opposing teeth. Despite the rise of tooth-colored alternatives like porcelain and zirconia, gold crowns continue to be the preferred choice for posterior teeth where aesthetics are less critical than functionality.

This guide explores everything you need to know about ADA code D2790, including its indications, procedural steps, benefits, drawbacks, and financial considerations. Whether you’re a dental professional or a patient considering this treatment, this article provides a thorough, evidence-based analysis of full gold crowns.

2. Understanding the ADA Code D2790 for Full Gold Crowns

The ADA Code D2790 specifically refers to a full cast metal crown predominantly made of gold or other high-noble metals (at least 60% noble metal content, with at least 40% gold). This code is used for billing and insurance purposes, distinguishing it from other crown types such as:

• D2740 (Porcelain/Ceramic Crown)

• D2750 (Porcelain-Fused-to-Metal Crown)

• D2780 (Full Metal Crown – Base Metal)

Key Features of a D2790 Crown:

• Made from a gold alloy (high noble metal)

• Cast using the lost-wax technique for precision

• Covers the entire tooth structure

• Ideal for molars due to strength and wear resistance

 Comparison of Different Crown Types

3. Indications for a Full Gold Crown

A dentist may recommend a full gold crown (D2790) in the following scenarios:

• Severe Tooth Decay: When a large portion of the tooth is damaged and cannot be restored with a filling.

• Fractured Teeth: Gold crowns provide superior strength for cracked or weakened teeth.

• Bruxism (Teeth Grinding): Gold’s malleability makes it resistant to wear from grinding.

• After Root Canal Treatment: To protect and reinforce a tooth post-root canal.

• High Occlusal Load Areas: Molars require a strong material to withstand chewing forces.

4. Contraindications and Alternatives

While gold crowns are highly effective, they may not be suitable for everyone. Contraindications include:

• Allergies to Metals: Though rare, some patients may have sensitivities to gold or other alloys.

• Aesthetic Concerns: Patients who prefer a natural-looking restoration may opt for ceramic crowns.

• Cost Restrictions: Gold crowns are more expensive than PFM or base metal alternatives.

Alternatives to Full Gold Crowns:

• Porcelain-Fused-to-Metal (PFM) Crowns (D2750) – Balance between strength and aesthetics.

• Zirconia Crowns (D2740) – Highly durable and tooth-colored.

• E-Max Lithium Disilicate Crowns – Best for front teeth due to superior aesthetics.

5. Step-by-Step Procedure for Placing a Full Gold Crown

Step 1: Diagnosis and Treatment Planning

• A thorough examination, including X-rays, determines if a gold crown is the best option.

Step 2: Tooth Preparation

• The dentist removes decay and shapes the tooth to accommodate the crown.

Step 3: Impression Taking

• A mold is taken and sent to a dental lab for crown fabrication.

Step 4: Temporary Crown Placement

• A temporary crown protects the tooth while the permanent one is being made.

Step 5: Crown Fabrication (Lost-Wax Technique)

• The lab creates a wax model, casts it in gold, and polishes it for a perfect fit.

Step 6: Final Cementation

• The permanent crown is checked for fit and cemented into place.

6. Advantages of Full Gold Crowns Over Other Materials

✅ Superior Durability – Lasts 20+ years with proper care.
✅ Biocompatibility – Rarely causes allergic reactions.
✅ Minimal Tooth Wear – Softer than porcelain, reducing wear on opposing teeth.
✅ Precision Fit – The casting process ensures an exact fit.

7. Disadvantages and Limitations

❌ High Cost – More expensive than other crown types.
❌ Metallic Appearance – Not ideal for visible teeth.
❌ Requires More Tooth Reduction – More natural tooth structure must be removed.

8. Cost and Insurance Considerations

• Average Cost: $1,000–$1,500 per crown.

• Insurance Coverage: Most plans cover 50–80% of the cost under D2790.

9. Common Questions About Full Gold Crowns (FAQs)

Q: How long does a gold crown last?
A: With proper care, gold crowns can last 20–40 years, far longer than porcelain alternatives.

Q: Can I get an MRI with a gold crown?
A: Yes, gold crowns are non-ferromagnetic and do not interfere with MRI scans.

Q: Are gold crowns safe?
A: Yes, gold is biocompatible and hypoallergenic for most patients.

Q: Do gold crowns look unnatural?
A: They are metallic, so they are best suited for back teeth where aesthetics are less critical.

10. Conclusion

The ADA code D2790 for full gold crowns represents one of the most durable and long-lasting dental restorations available. While they come at a higher cost and lack tooth-colored aesthetics, their unparalleled strength and biocompatibility make them an excellent choice for molars and high-stress areas. Patients and dentists alike continue to rely on gold crowns for their proven track record in restorative dentistry.

11. Additional Resources

• American Dental Association (ADA) Crown Codes

• Journal of Prosthetic Dentistry – Gold Alloy Research

• FDA Guidelines on Dental Crown Materials