To repair damage to the tooth’s biting surface, rather than
using a simple filling, or a crown, a dentist will often use
an inlay, or an onlay. Inlays and onlays can be made from
porcelain, gold, or composite or ceramic resin, although
porcelain is now becoming the material of choice because of
its strength and potential to match the natural color of
your tooth.
An inlay is similar to a filling and lies inside the cusp tips of the
tooth. They are custom-made to fit the prepared cavity and
are then cemented into place. An onlay is a more extensive
reconstruction that covers one or more cusps of a tooth.
Onlays are indicated in situations where a substantial
reconstruction is required. However, more of the tooth
structure can be conserved compared to the placement of a crown.
Inlays and onlays are applied in two dental visits. At the first visit,
the old filling, or decay, is removed, and the tooth is
prepared for the inlay / onlay. The dentist will then make
an impression of the tooth, and send this impression to a
dental laboratory. This impression will be used by the
laboratory to construct a custom-made porcelain, or gold
inlay / onlay. At this time the dentist will place a
temporary sealant on your tooth and schedule a second
appointment.
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At the second visit, the temporary sealant is removed.
Your dentist will then ensure that the inlay / onlay
fits properly in the tooth and does not interfere with your bite.
The inlay / onlay is then bonded into the tooth with a strong bonding resin,
and polished smooth.
Inlay |
Onlay |
TYPES OF DENTAL INLAYS AND DENTAL ONLAYS
There are two types of dental inlays and onlays:
: Tooth-Colored Inlays and Onlays
Several types of tooth-colored inlays and onlays have been developed primarily for use in larger defects in back teeth.
These are used in place of a crown (cap) or filling (restoration). They are made of porcelain, other ceramics, or resin (plastic).
These materials are made in a laboratory and are cemented into place using a liquid plastic form of cement.
Two appointments are required for their completion. These are beautiful restorations,
matching tooth structure nearly exactly, but they have not been used long enough for
optimal research knowledge about their long-term characteristics.
more
: Gold Inlays and Onlays
For nearly a century, cast gold inlays and onlays have been regarded by many dentists as the best,
longest-lasting method to repair teeth. Inlays fit within the biting surface of the tooth,
whereas onlays cover the top of the biting surface. Many of these restorations serve for most of a patient’s lifetime.
However, they are difficult to accomplish, expensive, and highly demanding of the dentist’s skill.
more
THE PROCEDURE OF DENTAL INLAYS AND DENTAL ONLAYS
Two appointments of approximately one to two hours per tooth.
ADVANTAGES & DISADVANTAGE OF DENTAL INLAYS AND DENTAL ONLAYS
Advantages :
- Highly esthetic
- No metal shows
- Strong once bonded to tooth
- Well-sealed tooth
- Will not stain
- Will insulate the tooth
- Well suited for large cavities
- Long lasting
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Disadvantages :
- More costly than amalgam or composite
- Can fracture
- Takes two appointments
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PATIENT MAINTENANCE
Avoid
biting hard objects in order not to fracture the porcelain.
Normal brushing and flossing. Use fluoride mouth rinse and
toothpaste as prescribed by your dentist. Same dietary
restriction (as above) for the longest restorative life.
RISK
Tooth sensitivity, short or long term, may be present in a few of these restorations.
If tooth sensitivity persists, endodontics (root canal therapy) may be necessary,
but this is infrequent. Some tooth-colored restorations break during service because
they are not as strong as those made of metal. If breakage occurs, the restoration can be remade.
Because these restorations have not been used as long as metallic restorations for back teeth,
knowledge about long-term service is not complete.
ALTERNATIVES
For back teeth, metallic restorations are the major alternatives. Silver amalgam and cast gold restorations are strong,
acceptable alternatives but are not as pleasing in appearance.
COST
Usually, these restorations require two appointments and some relatively complex laboratory work.
The necessary expertise and effort requires a cost that is near or equal to that of cast gold restorations,
or about five to eight times more than composite restorations.
RESULT OF TREATMENT
Porcelain inlays/onlays
can successfully achieve both esthetic and functional
results in restoring discolored or metal posterior teeth.
More conservative than full crown.
BEFORE & AFTER OF DENTAL INLAYS AND DENTAL ONLAYS
Before
large amalgam filling
Model
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After
onlay, inlay cementation
(the left one is inlay, the middle one is onlay, the right one is inlay)
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Before
large amalgam filling |
After
onlay, inlay cementation |
Before
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After
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Before
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After
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Before
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After
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Bonding material
NX3 Nexus kerr
Maxcem Elite kerr |