A couple of mils gap of filled silicone gease will seriously increase theta and junction temperature. We know because we measured it. The best grease is still a rotten heat conductor.
We even tried diamond-filled grease. It's not much better than the regular stuff. Do you know why?
The fets are shipped very flat; extrusions aren't. If the heat sink, or in our case the copper spreaders, are machined flat, the gap and gease can squish down below 100 micro-inches.
Once you fix the gap problem, the big problem becomes the spreading thermal resistance of the aluminum itself. Extrudable aluminum alloys don't conduct heat nearly as well as textbook "aluminum" numbers.
Hence the machined flat copper heat speaders. There are some machinable copper alloys that conduct heat almost as well as pure copper.
All the above was confirmed by experiment. We sold a lot of gradient drivers and they were reliable.
John Larkin Highland Tech Glen Canyon Design Center Lunatic Fringe Electronics