Dental Crowns | Dental Onlays | Dental Inlays

Porcelain inlays are a type of dental restoration that is used to repair and restore damaged or decayed teeth. They are similar to dental fillings, but they are larger and are used to restore a larger area of the tooth. A porcelain inlay is custom-made in a dental laboratory and is then cemented into place by Dr Alps. Porcelain inlays are made from a strong and durable ceramic material that is resistant to staining and wear. They can be color-matched to the patient’s teeth, making them virtually invisible when they are in place. Porcelain inlays are an aesthetic and long-lasting option for restoring damaged teeth.

• Appearance:
  They have an attractive natural appearance, unlike silver/gold are much less prone to picking up stains and discolouring than white filling materials.
  The porcelain can not only be shaped to mimic the original tooth but the patterns of the biting surface are naturally recreated with a little staining for added effect.
• Strength: 
  They are not as destructive to the remaining tooth as crowns, and by preserving much of the natural tooth, they increase the durability of the tooth.
• Wear:
  The materials used to make the inlays/ onlays are incredibly durable and will not wear away like fillings, even under the stress of grinding.
• Decay:
  They are less prone to decay at the margins because of the custom fit and the excellent seal they achieve.

• Durable: 
  They are more durable and last longer than fillings.
• Hygiene:
  As they are custom-made for individual teeth, they do not trap plaque in the same way that some fillings can and thus can be kept clean in the natural order of things.
• Expansion:
  They don’t expand and contract in the same way as filling materials thus reducing the stresses on the tooth.

• Two Visits: 
  Unlike fillings, they require two visits to complete, unless you opt for using a CEREC or CAD-CAM system.
• Cost: 
  They involve a laboratory stage, and as such, they are more expensive than the price of fillings but are cheaper than crowns.

• Wear:
  While they do not wear out themselves, some of the harder porcelain materials (such as zirconia) run the risk of wearing the opposing natural tooth – especially if the glaze is removed, when we adjust the bite. This isn’t a risk if the inlay/onlay bites on a filling or crown.
• Failure: They can, of course, fail. This would be a bonding issue and while the cement used is super strong, occasionally they can come off; in which case most of the time, they can simply be re-bonded (provided you still have it!). It is, as with any restoration (crowns, veneers, fillings) also possible for the tooth to get decay at the margins if there is a problem with the fit or you are not doing your part and keeping it clean.

Inlays and onlays can be useful for restoration in some situations, the main ones are:

• To restore a large cavity and weakened the tooth
• Instead of a filling
• 
Instead of a crown
• To avoid a root canal, post and crown.

• To restore a large cavity that weakened the tooth
• Dental caries (tooth decay)
• Food Traps
• If a tooth has a very large amount of decay, then a crown or an inlay/onlay becomes a more dependable long-term solution, compared to just having a filling. 
• Failed fillings
: Sometimes you may have had a large filling that has failed or another piece of that tooth that breaks away. It may be possible to repair the tooth or to replace the filling, but it is likely that at some point this will fail again and you will have to proceed to an inlay/onlay, or a crown. Often it is more sensible and more economical to proceed sooner to one of these indirect long-term treatments.
• Cracked teeth
  If part of a tooth fractures under massive biting forces (generally in people who have a grinding or clenching habit), inlays/onlays can be used to restore the part of the tooth that has broken.

It takes two appointments for the onlays treatment to be completed.

• 1st visit:
  At the first meeting, we will be numbing the area to be treated with a local anaesthetic to make the procedure most comfortable for you.
  Any decay or damage is removed, so you have a sound foundation of tooth structure to support your future Onlay.
  We use an intra-oral scanner to scan your tooth in 3-D to receive accurate measurements and eliminate the need to take moulds or impressions which can be unpleasant especially if you are a gagger.
  This scan is sent off to the dental laboratory, where a dental onlay is created that will fit your tooth correctly.
  Onlays are usually made of porcelain, which often most closely matches the colour of the tooth, but they can also be made from gold if you so desire.
  While your Onlay is being created at the lab, we create a custom-made temporary restoration (cover or filling) for your tooth to protect it until your next appointment.
  Allow yourself about 60minutes for this appointment.
• 2nd Visit:
  At the second appointment, we will remove the temporary restoration and then take time to ensure the Onlay fits correctly.
  Only when the Onlay fits correctly, we will bond the Onlay to the tooth with a strong resin adhesive.
  The Onlay treatment is completed with a polish to ensure a smooth and aesthetically pleasing finish.
  Allow yourself about 45 minutes for this appointment.

We may schedule you for a review appointment to ensure that you feel most comfortable with your new filling initially, any new tooth surface may seem a little odd, but you soon get used to the new tooth surface and how it feels and looks in your mouth.

Caring for your Onlay is just as important as for your natural teeth.
Although the restorations are made from the highest quality materials, your natural teeth and surrounding gums can still develop plaque and tartar build-up which could lead to gum disease.
A thorough at-home oral care routine and attending active maintenance appointments will add to the long-term success of your dental Onlay procedure and keep your teeth and gums healthy.

• Onlays are durable — Strength is one of the major advantages of Onlay. Depending on your aesthetic needs and budget, dental onlays can be made from gold, composite resin or porcelain and can last up to 10 years.
• Onlays help to strengthen teeth as they are bonded directly into the tooth, unlike traditional metal fillings which need cutting additional tooth structure for mechanical retention thereby actually reducing the strength of the teeth.
• Onlays prolong tooth life and prevent the need for more dental treatment in the future as there is a reduced chance of decay under the filling. A dental onlay extends over the cusps of the treated tooth.

Many patients are now choosing to have their amalgam fillings replaced with these tooth-coloured options. Inlays and onlays are the ideal solutions for replacing old fillings as they will strengthen your teeth and enhance the look of your smile.

Onlays and crowns cover the surfaces of teeth and help protect them from further decay, but onlays are more conservative treatments than crowns.
An onlay preparation only removes the decayed areas of the tooth to fit an onlay.
However, to fit a crown, we must also prepare some healthy tooth structure to offer a 360-degree full coverage up to your gum line or just above your gum line. The crown then fits over the remaining portion of the tooth offering full well-rounded protection to the tooth.
Just like crowns, Onlays can be made in Composite, Gold and Porcelain material.

Though white fillings may be suitable for smaller cavities or decay, there may be some concerns with larger fillings as white fillings are bonded chair-side with composite resin material than fabricated in a dental laboratory.
When the composite fillings are cured or hardened with blue light, it shrinks a fair bit. As it shrinks, it pulls in on the tooth and may crack the remaining thin enamel which is brittle.
A porcelain Onlay is injection folded or computer cut to fit your tooth. There is virtually no shrinkage stress with this method and therefore no cracking of the tooth.

The materials used to make Inlays and Onlays are stronger than other white filling materials.

Another difference when comparing Inlays and Onlays to other fillings is the potential risks regarding food traps and gum disease.
As white fillings do not compact down the cavity like traditional amalgam fillings, a fine gap may be left behind between the teeth that catch food especially fibrous food which could be annoying and painful, to begin with, but later could result in decay under the filling with the potential risk of nerve damage.
Food traps can also lead to potential gum disease and bone loss and eventually abscess formation.
If the cavity extends below the gum line and there is a ledge or defect around the collar of the filling, it can be difficult to manage that area.
As Onlays and Inlays are fabricated in the laboratory, they fit the collars of your tooth quite precisely allowing you easy access for flossing and thereby avoiding the risk of decay under the filling or potential gum disease.