One innovative way to restore a tooth that has been moderately to extensively destroyed by decay, previous drilling, or fracture is with a porcelain inlay or onlay. An inlay is a restoration in which a portion of the occlusal (biting) surface is restored. An onlay will restore more of the entire biting surface of the tooth. You might need an inlay alone, an onlay alone, or a combination inlay/onlay. This is considered a very conservative restoration.
The porcelain material produces an excellent esthetic result. The porcelain inlay or onlay is bonded to the tooth, making it very strong. It can be used with wonderful results in small, medium, and even large restorations lasting more than 12 years, relatively trouble-free.
An outside laboratory is involved in the construction of this type of restoration. During the 2- to 3-week processing time while the inlay or onlay is being made, the tooth will be protected by a temporary restoration. Porcelain inlays and onlays do have some disadvantages. They are more expensive to make and place and they take two appointments to complete. They must be adjusted and polished well or they can cause wear of the opposing enamel, exactly like a porcelain fused to metal crown.
Advantages include the excellent esthetics, high strength, predicted longevity, and conservative preparation. If the porcelain does chip, it can be repaired. However, you should not chew ice cubes, “jaw breakers,” or other hard candy with these or any other type of restoration.
Anything that you put in your mouth that can break a real tooth can break this type of restorative material.
For patients who want a strong, long-lasting, conservative restoration that very closely matches a tooth, porcelain is possibly the best choice. All things considered, it is not as expensive as it might appear. Once it is finished, the tooth, if cared for properly, should not have to be drilled again for years. It does allow the conservation of most of the natural tooth. Remember, our goal is to preserve as much of your natural tooth structure as possible.
Inlays and onlays are often referred to as partial crowns. They use the existing tooth as a base and fit the inlay or onlay onto the tooth. This is done to strengthen the tooth, restore its shape, and prevent further damage. An inlay is done when there is no damage to the cusps of the tooth and the inlay can be placed right on the tooth. An inlay is used when the damage is a little more extensive. The decayed area of the tooth is first removed during the procedure. A mold of the tooth is then taken and sent to a dental lab. They create a restoration made from porcelain, gold, or a composite resin. The restoration takes about 2-3 weeks to make, so a temporary inlay or onlay will be placed on the tooth for that time. During your next visit the inlay or onlay will be placed into your mouth and set with cement. Your tooth will look natural and you or anyone else won't be able to tell the difference.
Dr. Michael T McClure, DMD
1409 Kingsley Ave, Suite 7A
Orange Park, FL 32073