‘Gold’ Lost in Restoration: Evaluation of Core Morphology of Custom Metal Posts and Cores, and Analysis of Precious Metal Debris

(1) Objectives: To investigate the deviations between the morphological dimensions of finished cores and desired dimensions made by three available fabricating techniques. To assess the precious metal loss in custom precious metal post and core restorative treatment in the dental clinic. (2) Methods: Titanium posts and cores were fabricated using three different techniques: digital scanning impression technology, digital scanning wax-pattern technology, and the traditional lost-wax casting method. Geomagic Studio was used to fit the scanned model data to the digital design data of the expected preparation and to analyze the 3D deviations between the two. Precious metal debris from the precious metal post and core was collected, processed, weighed and analyzed for precious metal elements by energy-dispersive X-ray spectroscopy layered images. (3) Results: In all 48 pairs of models, there were positive and negative deviations, with the largest mean positive deviation of (0.752 ± 0.037 mm) for models made by the semi-digital scanning wax-pattern technique. A total of 7001.3 mg of metals was recovered from the waste streams collected, which contained precious metals—mainly gold, silver, and platinum. (4) Conclusions: There were discrepancies between the custom core and the expected preparation regardless of the fabrication process used. The digital scanning impression technology showed better dimensional rationality of crown cores. Custom precious metal posts and cores can have an average precious metal loss of 129.7 mg per case in the dental clinic.