Inlays / Onlays

When over 1/2 of the tooth’s biting surface is damaged a dentist will often use an inlay or onlay.

What are inlays and onlays?

Inlays and onlays can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth; an onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.

Traditionally, gold has been the material of choice for inlays and onlays. In recent years, however, porcelain has become increasingly popular due to its strength and color, which can potentially match the natural color of your teeth.

How are they applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the filling being replaced or the damaged or decaying area of the tooth is removed, and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth taken, which is sent to a lab for the fabrication of the restoration. Dr. Stephenson will then apply a temporary filling on the tooth and schedule the next appointment.

At the second appointment, the temporary is removed. Dr. Stephenson will then make sure that the inlay or onlay fits correctly. If the fit is satisfactory, the inlay or onlay will be cemented or bonded to the tooth with a strong resin and polished to a smooth finish.

Considerations

Traditional silver fillings can reduce the strength of a natural tooth by up to 50%. As an alternative, inlays and onlays, being bonded directly onto the tooth using special high-strength resins, can actually increase the strength of a tooth by up to 75%. As a result, they can last from 10 to 30 years. In some cases, where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide an excellent alternative.

Typically they are made with a traditional crown quality in a lab but are much more conservative. Only the damaged portion of the tooth is removed and the remaining tooth is preserved.

Composite, if used in very large defects, we consider a temporary solution as they are often not strong enough for long term and can be unpredictable in bridging large gaps between teeth. If excessively large, there is a higher instance of chipping under the huge force the jaw is capable of generating. Ceramic and gold inlays and onlays are strong, have natural contours designed outside the mouth, and fit large defects. Ceramics inlays and onlays also have beautiful esthetics created outside the mouth, and the shrinkage of the cured composite is reduced to a very thin film thickness of cement. These are cemented and require isolation from oral fluids for a very short time, just during the cementing process. This is different and superior to the direct composites that must be entirely made in the mouth in a contaminant free environment during the entire time of placement. This increases the predictable longevity of Inlays and Onlays.

The result is a beautiful smile!