Cast Gold Inlays/Onlays

Administer anesthetic. Remove temporaries. Place extra-heavy rubber dam.
Casting should be highly polished and cleaned in the laboratory prior to seating, especially occlusal grooves and fossae.
Try in each casting. Ensure contacts are correct and if necessary, adjust. The casting is never fully seated until cementation occurs.
Remove composite build-ups by making a slit in the material with a bur. The build-up will practically fall out of the preparation due to the calcium hydroxide separator placed earlier.
Clean out excess calcium hydroxide.
Apply cavity varnish over all dentin areas using a sharpened instrument for exact placement.
Apply a slow setting thin mix of Type I cement (which has a thin film thickness) into the cavity preparation, filling the voids in the preparation with cement. Place additional cement on the underside of the cast gold restoration.
Carry the inlay to the preparation. Press it firmly to place with hand pressure and remove the excess cement. Continue placing pressure with the seating stick, malleting and removing cement until cement is no longer expressed at the margins. Hold for 30 seconds prior to finishing.

Finishing/Polishing:

Use a 1/2 inch medium garnet disc in a straight handpiece to reduce the gold and tooth to the same plane on all surfaces (use contra-angle with grit in to reduce mesial-lingual, where necessary, for both maxillary and mandibular restorations). Air should be blown continuously on the tooth to prevent overheating during all discing, stripping and polishing procedures.
Remove scratches with 1/2 inch fine sand disc (use contra-angle with grit in for mesial-lingual, if necessary). Any areas of the tooth that are soft are best disced with fine sand rather than medium garnet as the tooth structure will be reduced faster than the harder gold.
Place medium garnet extra-long strip (tapered for an inch or inch and a half on one end for ease of insertion) through interproximal to finish gingival wall.
If the gingival margin lies on cementum, a narrow medium cuttle extra-long strip should be used to finish the casting rather than the garnet strip. Take care to avoid ditching the cementum.
Use fine and extra-fine narrow, extra-long cuttle strips to reduce the size of scratches.
Complete discing with fine cuttle discs until all scratches have been removed.
Polish with flour of pumice #4. NOTE: Do not use coarse pumice as it will destroy the finish achieved with the fine cuttle disc.
Use dry tin oxide powder over casting for final polish. Blow off excess tin oxide while utilizing a ribbed cup (webbed cup will throw powder away from tooth) at low speed to avoid heating the tooth.