Clinical necessity of cast titanium fixed prostheses in Japanese health insurance system

Abstract

The application of composite resin crowns by CAD/CAM has been expanded to molar restorations. However, problems of crown detachment and fracture remain, especially in the second molars with less height for metal-allergic patients. Since titanium and titanium alloy show high mechanical strength, corrosion resistance, and biocompatibility, a group in the Japanese Society for Dental Materials and Devices investigated titanium and titanium alloy cast crowns as alternative prosthodontic devices in such cases. As the result of a proposal made with the Japan Prosthodontic Society, the grade 2 titanium cast crown has been listed in the Japanese health insurance system since June 2020. Because of the necessity of special casting machines and investment materials, it was approved as a new technology. Since the price of Ag-Pd-Au dental casting alloy keeps increasing, titanium and titanium alloys are also considered promising candidates as substitutive materials.