Porcelain Inlay and Onlay

An excellent way to restore teeth with small to moderate decay
The Problem:
        • Any level of decay or moderate fracture on a portion of any tooth
        • Need for a long-term, durable restoration
        • Desire to limit the amount of healthy tooth structure removed
        • Need to strengthen and reinforce tooth

Inlays and Onlays

Unlike large, ugly metal fillings of years past, our dentists provide a more attractive restoration that actually strengthens the tooth. Inlays and onlays provide healthy, beautiful restorations for your teeth.

In recent years, dentists have learned that the metal filings in your mouth act much like metal does outside the mouth. Exposed to heat and cold, such as hot coffee or ice cream, the metal fillings in your teeth expand and contract. As they shift, they can actually weaken the teeth they were meant to protect. Often, the expansion and contraction leads to cracking of the entire tooth.

As the filling expands and contracts, it can also leave a small opening where harmful bacteria can enter and become trapped, leading to further decay of the tooth. Rarely do we remove silver fillings without finding additional decay underneath.

An inlay or onlay is a much more conservative restoration for the tooth than a metal filling. While traditional fillings can reduce tooth strength by up to 50%, inlays and onlays made of high strength porcelain can actually increase tooth strength by up to 75%, lasting from 10 to 30 years.

Inlays
Inlays, similar to fillings, are used inside the cusp tips of a tooth. Inlays are created out of fired porcelain, allowing us to perfectly match the color of your natural tooth, making the restoration invisible to the naked eye.

Onlays
Onlays are made of fired porcelain, just like inlays. However, onlays are a more substantial reconstruction, extending out over one or more of the cusps of the tooth. Where a crown may have been necessary, an onlay can often be used to repair the damaged portion of the tooth, leaving much more of the original tooth structure intact.

Advantages:
Inlays and onlays are incredibly strong due to the fact that they are created in a laboratory. This protects the tooth from fracturing and actually strengthens the tooth. In addition, inlays and onlays fit almost perfectly into the prepared surface of the tooth, reducing the size of the seam between the restoration and the tooth. This helps keep decay from eventually occurring under the restoration.

Inlays and onlays require the removal of only decayed and fractured areas of the tooth, leaving more healthy tooth structure intact. This can help prevent the expense of root canal therapy in the future.

The Solution:
Decay is removed and cleaned from the tooth and core build-up is placed to insulate the pulp. Then a highly accurate impression or mold is made of the prepared surface. This mold is used to create a model of the tooth which is then sent to a special laboratory that will create a porcelain (tooth colored) restoration called an inlay or onlay. Approximately one week later the inlay/onlay is available for cementation. The inlay or onlay is then cemented into the prepared surface of the tooth.

An inlay covers only one or two surfaces of the tooth and is used to restore a small amount of decay. An onlay actually covers one or more cusps (the chewing surface of the tooth.) and offers greater protection for moderately fractured teeth.

Often it is advantageous to whiten teeth before treatment so that the new restoration color matches the desired whiter, brighter smile.

Cemented Inlays/Onlays

As a person ages it becomes more important to restore teeth with materials that add strength and functions. As teeth get older, they become more brittle and susceptible to recurrent decay and fracture – especially around amalgam fillings. When this occurs, root canal, or even extraction can become necessary. So, there is a real need for a restoration that will add strength, plus have excellent esthetics… such as cementable porcelain inlays/onlays. In dentistry, today there are many different materials and techniques used to fix teeth. Recently, white “bonded-composite” fillings have replaced the old fashioned “bonded-amalgam” filling.

Unfortunately, many of these teeth, when the old silver filling is removed, show extensive decay not evident on X-rays. Also, the old filling produces internal stress fractures in the remaining tooth structure, which results in this part of the tooth not being able to support a white or silver filling. Previously, dentists had only two alternatives, a gold filling, or a full crown (cap). Both were either not aesthetically pleasing, or not conservative in the tooth reduction required to place restoration successfully. Fortunately, now your teeth can be both restored aesthetically, and save more of the healthy parts of your tooth. Porcelain restorations are pieces of ceramic material that matches the natural color of other teeth in your mouth. Dental research has shown that when these porcelain pieces are cemented into your tooth, the strength of your tooth returns to 100% of the original tooth’s structure! The ceramic material is compatible with the tissue in your mouth, and is high grade anti-abrasive and plaque resistant.

Inlays An inlay fits within the contours of the tooth, and is cemented to the remaining tooth structure. An inlay is indicated when the chewing surface of the restoration is too big to support a filling. A porcelain or gold inlay will reinforce and resist chewing wear and tear better than any filling material.		Onlays An onlay fits within the contours of the tooth and covers part or all of the chewing surface needing to be restored. It goes far beyond a filling in returning the original strength and chewing power to that missing part of your tooth. Another benefit is that it looks like your tooth did before any problem existed in the tooth. Finally, the tooth preparation needed for an onlay is less than for a full crown (cap). This more conservative procedure can prevent extra dental therapy from being needed such as root canal, or crown lengthening, which is more likely with a crown treatment.