True, but during the Hunt's market manipulation, the price of gold went
to $800/oz and silver to $50.  Everything we use made of these metals
(gold alloys, x-ray film) skyrocketed in price immediately.  When the
prices collapsed, it took a very long time for the end user (me) to see
the prices start to decrease--and they never returned to what they were
a few years before.
    Whatever the cause, the spike in gold prices meant that the industry
had to find substitutes for gold that dentists and labs were willing to
use--and they did--regardless what happened after that in the
commodities markets.

Steve

    Not exactly.  Some labs and some dentists will show a decided
preference for high noble metals.  They are easier to work with, and
some believe yellow alloys (notably with Cap-tek crowns, which are
really a different kettle of fish altogether), give a warmer, more
cosmetic appearance.  I don't think this last is really a consideration
with regard to molar crowns (I should say that I have one crown in my
mouth, a full-cast, all high-noble crown on a lower second molar with no
porcelain).
    The preferences of the operator are not to be discounted; still, I have
no problems and have seen no significant differences in crowns holding
up, porcelain fractures etc. with non-precious alloys.
    I will make one minor caveat--an observation by my brother that he
still sees a greater incidence of inflammation at the gumline with
non-precious alloys.  He feels he has only seen this in female patients.
 If true, there is no way to know what component of the alloy the
patient is responding to; as I said few of these alloys contain nickel
anymore.  But a patient can develop a sensitivity at least theoretically
to just about anything, including some of the components of even
high-noble alloys.
    Personally, I think that this last consideration (not to discount my
brother) is less important than other considerations such as proper
contacts, contour and esp. not burying the margin of the crown half a
mile under the gum.
    I agree BTW with what Bill says about the fees being very low, but it
isn't clear to me whether this is the entire fee or just your copayment
in an insurance situation.
    There is also another health issue I should mention, though it doesn't
involve you--but does involve dental and lab personnel.  A longtime
poster to this newsgroup became a crusader for the removal of beryllium
from casting alloys.  Beryllium is used to increase hardness and other
mechanical properties.  It is apparently still used in some.  Beryllium
is exceptionally toxic when inhaled, and this gentleman's wife developed
beryllium lung disease as a consequence of working in a dental lab and
breathing the dust.  I agree with him that there is no place for this
metal in lab casting alloys, and that it poses an obvious and
demonstrable hazard to lab personnel.

Steve

__________________________

The dental labs in my town can provide a porcelain-fused-to-metal crown
with at LEAST four different types of metal: non-precious alloy, a
low-percentage gold alloy, a high-percentage gold alloy, and a "Captek"
style crown (very, very thin high-gold alloy under thicker porcelain).

The costs of the local labs' porcelain-fused crowns usually do not vary
by more than about $100 from top to bottom. In the lab I use, the
variation is certainly not anywhere near $200.

The greatest cost in crown fabrication is usually the labor, not the
materials.

For this reason, SOME labs have started sending out their cheaper
crowns to overseas subcontractors. As the labor is cheap in these
offshore locations, those labs often show a LARGE variation between
their cheapest crowns and their most expensive. In these cases, the
variation is not due to the materials used, but to the fact that
foreign labor is used.

The local labs in my town make all their crowns themselves, so the cost
variations are due to different materials, and the actual weight of the
gold alloy used in a particular crown.

As the labor costs are the same, the cost variations of gold vs.
non-gold porcelain fused crowns are minimal, as stated above.

Best regards,
- dentaldoc