Inlays and Onlays - Lyons Dental

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Inlays and Onlays

In dentistry, an inlay is usually an indirect restoration (filling) consisting of a solid substance (as gold, porcelain or less often a cured composite resin) fitted to a cavity in a tooth and cemented into place. This technique involves fabricating the restoration outside of the mouth using the dental impressions of the prepared tooth, rather than placing a soft filling into the prepared tooth before the material sets hard.

An onlay is the same as an inlay, except that it incorporates a replacement for a tooth cusp by covering the area where the missing cusp would be. Crowns cover all surfaces of the anatomical tooth crown.

An impression of preparation for restoration with a DO gold inlay on tooth #5. The “DO” designation indicates that the gold serves as a restoration for the distal and occlusal surfaces of the tooth. This tooth was prepared and the inlay will be fabricated according to the R.V. Tucker method of gold inlay preparation. Notice how the line angles of the impression for the inlay are very sharp and precise; this is achieved using carbon-tipped stainless steel instruments. The salmon-colored polyvinylsiloxane impression material is less viscous than the blue and is able to capture better detail for the tooth being restored.

Sometimes, a tooth is planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would compromise the structural integrity of the restored tooth or provide substandard opposition to occlusal (i.e., biting) forces. In such situations, an indirect gold or porcelain inlay restoration may be indicated.

Comparison of inlays and direct fillings

When an inlay is used, the tooth-to-restoration margin may be finished and polished to a very fine line of contact to minimize recurrent decay. Opposed to this, direct composite filling pastes shrink a few percent in volume during hardening. This can lead to shrinkage stress and rarely to marginal gaps and failure. Although improvements of the composite resins could be achieved in the last years, solid inlays do exclude this problem. Another advantage of inlays over direct fillings is that there is almost no limitations in the choice of material. While inlays might be ten times the price of direct restorations, it is often expected that inlays are superior in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers. However, this might be only the case for gold. While short term studies come to inconsistent conclusions, a respectable number of long-term studies detect no significantly lower failure rates of ceramic or composite inlays compared to composite direct fillings. Another study detected an increased survival time of composite resin inlays but it was rated to not necessarily justify their bigger effort and price.

An MO gold inlay on tooth #3, the “MO” designation indicating that the gold serves as a restoration for the mesial and occlusal surfaces of the tooth

Onlays

When decay or fracture incorporate areas of a tooth that make amalgam or composite restorations inadequate, such as cuspal fracture or remaining tooth structure that undermines perimeter walls of a tooth, an onlay might be indicated. Similar to an inlay, an onlay is an indirect restoration which incorporates a cusp or cusps by covering or onlaying the missing cusps. All of the benefits of an inlay are present in the onlay restoration. The onlay allows for conservation of tooth structure when the only alternative is to totally eliminate cusps and perimeter walls for restoration with a crown. Just as inlays, onlays are fabricated outside of the mouth and are typically made out of gold or porcelain. Gold restorations have been around for many years and have an excellent track record. In recent years, newer types of porcelains have been developed that seem to rival the longevity of gold. If the onlay or inlay is made in a dental laboratory, a temporary is fabricated while the restoration is custom-made for the patient. A return visit is then required to fit the final prosthesis. Inlays and onlays may also be fabricated out of porcelain and delivered the same day utilizing techniques and technologies relating to CAD/CAM dentistry.

A systemic review found that the most common cause of onlay failure is ceramic fracture, followed by ceramic de-bonding from the tooth structure, and the occurrence of secondary caries which is seen as a discolouration at the margins of the restoration. High failure rates were associated with teeth that had previous root canal treatment, and with patients who exhibit para-functional habits such as bruxism , or teeth clenching.

 

How Do I know What Type of Dentistry is Right For Me?

Making a decision concerning something that defines who you are to many the first time they see you can be intimidating and confusing. Dr. John-Varghese will walk you step by step through the decision process helping you understand every aspect.

CEREC Crowns or Just a Filling
Chairside Economical Restorations of Esthetic Ceramic or CEREC® for short is a new state-of-the-art method of reconstructing tooth restorations. This new technology has revolutionized ceramic restorations such as crowns and veneers for patients so that there is no longer a wait between preparing the restoration and finally receiving the finished product.
Dental Sealant or General Cleaning
Sealants are thin layers of resin that are placed on the pits, fissures, and grooves of molars to prevent decay on these surfaces. The majority of decay on back teeth starts in the grooves and pits of chewing surfaces, especially during the first few years after their eruption. Sealing these surfaces with composite resins prevents this kind of decay.
Zoom Teeth Whitening
The procedure is simple. It begins with short preparation to cover your lips and gums, leaving only your teeth exposed.
We then apply the proprietary Zoom! whitening gel, which is designed to be used specifically with the Zoom! light. The light and gel work together to gently penetrate your teeth, breaking up any stains and discoloration.

  • During this time you can relax.
  • The gel is applied for 3-4 fifteen minute sessions, for a total treatment time of 45-60 minutes.
  • Finally, you go home with your brighter, whiter smile. We also provide you with touch-up trays so you can maintain your new smile.
Dental Implant Restoration
During the last 20 years, dental implants have become a desirable alternative to other methods of replacing missing teeth. Excellent success rates and a range of available options give dentists a variety of new ways to treat and replace lost teeth.

Your dentist can evaluate your case and tell you if you are a candidate for dental implants. Structurally, a dental implant is a titanium-based cylinder that replaces the missing tooth root. After a period of time, other parts are placed on the implant to enable your dentist to eventually place a crown (cap) on the implant. Implants can also be used to support full or partial dentures, dramatically improving denture retention and stability.

Vaneers and Laminates

Veneers and Laminates are a thin shell of porcelain or resin that is bonded to the surface of the teeth. This can change their shape, shade, and position to improve the cosmetics of your teeth and smile. They are also used to replace and restore any lost tooth structure where indicated.

Your dentist will do a complete examination of your teeth to determine if veneers are ideal for you. Veneers often provide the opportunity to dramatically transform the aesthetics of your teeth and smile.

Still Have Questions?

LYONS DENTAL CONTACT, HOURS AND SERVICES

Lyons Dental

1519 Lyons Road, Centerville Ohio 45458

Lyons Dental
1519 Lyons Road
Centerville Ohio 45458

Phone: 937.872.2046
FAX:  937.428.4249

Mon 8:00AM - 4:00PM
Tue  8:00AM - 4:00PM
Wed 8:00AM - 4:00PM
Thu 7:00AM - 2:00PM