2 - Inlays, onlays and veneers Flashcards
1
Q
What are the clinical stages of indirect restorations?
A
- prep
- impression and occlusal records
- temporisation
- cementation
2
Q
What is an inlay?
A
- intra-coronal restoration made in the lab
- “filling made out of the mouth”
- no cuspal coverage
- used in occlusal ± interproximal cavities, to replace failed direct restorations
3
Q
What are the different materials used for inlays?
A
- composite
- porcelain
- gold
4
Q
What are the different materials used for onlays?
A
- composite
- porcelain
- gold
5
Q
What are the different materials used for veneers?
A
- composite
- porcelain
- gold
6
Q
What are indications for inlays?
A
- premolars or molars
- occlusal restorations ± mesio- or disto-
- can be used in MOD if isthmus is narrow
- low caries rate
- no cuspal coverage required
7
Q
What are advantages of inlays?
A
- superior margins and materials
- do not deteriorate over time
8
Q
What are disadvantages of inlays?
A
- time
- cost
9
Q
What burs are used to prepare inlays?
A
- No. 170L
- No.169L
- coarse-grit flame diamond
- flame
10
Q
What burs are used to prepare onlays?
A
- No. 170L
- No.169L
- coarse-grit flame diamond
- flame
11
Q
What is the preparation for a ceramic inlay?
A
- 1.5-2mm isthmus
- 1.5mm depth
- 1mm shoulder/chamfer margin
- butt-joint cavosurface margins (no bevel)
12
Q
What is the preparation for a gold inlay?
A
- 1mm isthmus
- 1.5mm depth
- 0.5mm chamfer margin
- 15-20 degree bevel upper 1/3 of isthmus wall
13
Q
What are direct temporary materials that can be used to temporise preparations?
A
- Protemp
- kalzinol (ZOE)
- clip (composite)
- GI
14
Q
What do you use to cement ceramic inlays?
A
- NX3
- RelyX (RMGI)
15
Q
What do you use to cement ceramic onlays?
A
- NX3
- RelyX (RMGI)
16
Q
What do you use to cement gold inlays?
A
- AquaCem
- Panavia
- RelyX (RMGI)
17
Q
What do you use to cement gold onlays?
A
- AquaCem
- Panavia
- RelyX (RMGI)
18
Q
What is an onlay?
A
- extra-coronal restoration made in lab
- has cuspal coverage
19
Q
What are indications for onlays?
A
- sufficient occlusal tooth loss
- buccal ± palatal/lingual cusps remaining
- remaining tooth tissue weakened (eg caries)
- pre-existing large restoration (MOD with wide isthmus)
- when strength is required (ie bruxism)
20
Q
When are onlays used?
A
- tooth wear cases to increase OVD
- fractured cusps
- restoration of RCT teeth
- replace failed direct restorations
21
Q
What is the preparation for a ceramic onlay?
A
- working cusp 2mm reduction
- non-working cusp 1.5mm reduction
- 1.5mm depth
- butt-joint cavosurface margin (no bevels)
- 1mm shoulder/chamfer margin
- 1mm proximal box clear of contact points
22
Q
What is the preparation for a gold onlay?
A
- non-working cusp 0.5mm reduction
- working cusp 1mm reduction
- 1.5mm depth
- 15-20 degree bevel upper 1/3 isthmus wall
- 0.5mm chamfer margin
- 1mm proximal box clear of contact points
23
Q
What is the first appointment for inlays/onlays?
A
- LA (if not RCT)
- reduction template
- impression for temp
- tooth prep
- make temp
- bite reg and record shade
- cement temp
24
Q
What is the first appointment for veneers?
A
- LA (if into dentine/anxious)
- reduction template
- impression for temp
- tooth prep
- make temp
- bite reg and record shade
- cement temp
25
What is the second appointment for inlays/onlays?
- remove temp
- isolate, clean and dry tooth
- try in and assess fit
- cement if happy
- any minor occlusal adjustments
26
What is the second appointment for veneers?
- remove temp
- isolate, clean and dry tooth
- try in and assess fit
- cement if happy
- any minor occlusal adjustments
27
What are alternatives to inlays/onlays?
- large direct restoration
- crowns
- extraction
28
What are indications for veneers?
- improve aesthetics
- change teeth shape, colour or contour
- correct peg laterals
- reduce or close interproximal spaces
- align labial surfaces of instanding teeth
- enamel defects
29
What are contraindications for veneers?
- poor OH
- high caries rate
- gingival recession/root exposure
- high smile line
- if extensive prep required
- teeth outwith the arch
- extensive NCTSL
- heavy occlusal contacts
- severe discolouration
30
What is the preparation for veneers?
- can be none
- 0.3mm cervical reduction with slight chamfer margin
- 0.5mm midfacial reduction
- 1-1.5mm incisal reduction
31
What are the different types of veneer preparation?
- feathered incisal edge
- incisal bevel
- intra-enamel (window)
- overlapped incisal edge
32
What is the Gurel technique?
- mock up created
- putty impression taken and compared to dentition before preparation
- relevant teeth prepared
33
How can you temporise veneer prep?
- may not require temp if enamel is thick enough
- spot bonded composite build up (no etch, small dot of bond and composite applied)
- temporary veneer (Protemp)
34
What do you use to cement a veneer?
- NX3
- RelyX Unicem
35
What are alternatives for veneers?
- no treatment
- microabrasion
- penetrative resin restorations
- direct composite restoration
- crowns
