Which material is considered best for pulp and gingival health in a large cavity?

Gold onlays are often considered the best material for pulp and gingival health in large cavities due to their biocompatibility and strength. The properties of gold make it an excellent choice for restorations, especially in large cavities where durability is important. Gold has a lower thermal conductivity compared to other materials, which helps to minimize thermal shocks to the pulp. Additionally, gold is less corrodible, leading to a reduced risk of adverse reactions in the surrounding tissue.

In terms of gingival health, gold onlays fit well and provide a smooth surface, which helps reduce plaque accumulation. This smoother interface can lead to better periodontal outcomes as it minimizes the irritation of the gingiva and allows for easier maintenance of oral hygiene.

Other options may not perform as well for pulp and gingival health. For instance, composite resins, while aesthetically appealing and easy to apply, can have higher thermal conductivities and potential to cause sensitivity problems over time. PFM crowns may involve more tooth structure removal and can sometimes lead to irritation of the gums if the margins are not perfectly sealed. Acrylic fillings, while useful in temporary situations, lack the long-term durability and biocompatibility typically necessary for larger restorations.