Lost in the middle of the simple treatments and full-mouth reconstructive surgery is an array of restoration techniques and procedures that serve important roles in their own right.
Dental filling procedures, for example, are easily some of the most widespread and routine treatments available today. The average person, for instance, has seven fillings, also known as a direct or indirect restoration. When most people use the term “filling,” they are typically referring to a direct restoration in which a flexible restorative material, such as a dental amalgam, is placed into or onto a damaged tooth to restore its structural integrity. As it is typically applied, dental fillings are most commonly used to repair and reinforce decayed teeth. However, not all tooth restoration techniques are direct dental fillings. Rather allowing the shaping and curing process to occur in situ in the mouth itself, an alternative is to fabricate the dental filling in an external environment where variables can be better controlled. This approach is known as an indirect restoration technique and is best represented in the form of dental inlays and dental onlays.
A dental inlay is a dental filling that has been fabricated, shaped, and allowed to cure in a controlled environment outside of a patient’s mouth. This comes with many benefits including better accounting for shrinkage during the curing process, greater accuracy, and better quality control overall.
One of the biggest weaknesses of direct application composite pastes, such as dental amalgam, is the material’s tendency to slightly shrink as it hardens. This can result in gaps between the restorative filling and the rest of the tooth resulting in reinfection and more tooth decay. Poorly executed direct restoration techniques are the cause of significant recurrent tooth decay and in severe cases, complete edentulism or tooth loss. Dental inlays significantly reduce the risks of recurrent infections.
During the dental inlay process, impressions of the teeth are obtained. A mold is then created which will serve as a basis for the fabrication of an accurate and personalized dental inlay made of a variety of dental-grade materials including gold and ceramic. Once the custom inlay is complete, it can be placed into the damaged tooth restoring it back to its natural strength.
Like a dental inlay, a dental onlay is also considered an indirect restoration technique. That means that the actual filling is fabricated and cured outside of a patient’s mouth utilizing CAD/CAM technologies for exceptional accuracy. As a result, onlays come with some advantages over cured-in-place solutions and traditional dental amalgam pastes with better quality control and lower rates of recurrent tooth decay. Onlays are particularly useful for restoring teeth that have suffered damage to their structural parameters, such as a fracture, chip, or crack, or damage to a tooth’s cusp. Onlays essentially “onlay” or cover the damaged perimeter walls or missing cusp.
The dental onlay process is quite similar to that of a dental inlay procedure. Impressions are taken and made into a mold. The onlay is then manufactured utilizing CAD/CAM computer technologies and are placed onto the target tooth once complete.
While awaiting either an inlay or an onlay, many patients receive a temporary restoration or prosthesis to help preserve and protect the tooth until the final product is ready for placement.
There are many reasons dentists recommend inlays or onlays over other tooth restoration options. Following are some of the reasons as well as benefits of dental inlays and onlays:
Based on many factors, there are situations in which fillings are the better option versus inlays and onlays. However, a determination is best made by a prosthodontist like Dr. Mamaly Reshad who is trained to evaluate the ideal treatment options for every patient.