BDS3 Treatment planning - Inlays, Onlays and Veneers Flashcards
what do you use for mounted study modelS?
Semi- or fully adjustable articulator
What are the conventional clinical stages for indirect restorations
o 1) Preparation
o 2) Temporisation
o 3) Impressions and occlusal records
o 4) Cementation
what do you use for chairside indirect restorations?
CAD-CAM
- milled from block of ceramic
diff between inlay and only?
both made in lab
- inlay intra coronal rest onlay extra coronal rest
what are some types of inlays and onlays?
Gold
Composite
Porcelain
what are some uses of inlays?
Occlusal cavities
Occlusal/interproximal cavities
Replace failed direct restorations
what are some indications of inlays?
Premolars or molars
Occlusal restorations
Mesio-occlusal or disto-occlusal restoration
MOD
* If kept narrow
o If not – consider onlay
Low caries rate
advantages of inlays?
Superior materials and margins
Won’t deteriorate over time
disadvantages of inlays?
Time
Cost
how to do an inlay prep for ceramic and gold?
ceramic
- 1.5 -2mm isthmus width
- 1.5mm depth
- 1mm min shoulder or chamfer margin
Gold
- 1mm isthmus width
- 1.5mm depth
- 0.5mm chamfer margin
occlusal key/dovetail
consider additional internal accessory retention features
- like grooves
alternative to inlays?
- Direct temporary materials
o Kalzinol (ZOE)
o Clip (a composite based material)
o GI
why do you not check occlusion of ceramic inlays?
weak when not cemented and may fracture
indications for onlays?
Sufficient occlusal tooth substance loss
* Buccal and/or palatal/lingual cusps remaining
Remaining tooth substance weakened
* Caries
* pre-existing large restoration
o MODs with wide isthmuses
when are Cast metal inlays/onlays preferable to amalgam?
Higher strength needed
Significant tooth recontouring required
uses of onlays?
Tooth wear cases
* Increase OVD
Fractured cusps
Restoration of root treated teeth
Replace failed direct restorations
how to do an onlay prep for porcelain and gold?
porcelain
- non working cusp 1.5mm reduction
- working cusp - 2mm reduction
gold
- non working cusp 0.5mm reduction
- working cusp 1mm reduction
proximal box (if require0 1mm
margins
- porcelain - 1mm shoulder or chamfer
- gold - 0.5mm chamfer
alternatives to inlays and onlays?
o Large direct restorations
o Crowns
o Extraction
what is a laminate veneer?
A laminate veneer is a thin layer of cast ceramic that is bonded to the labial or palatal surface of a tooth with resin.
types of veneer?
Ceramic
Composite
Gold
what are some intrinsic indications for veeners?
- Non-vital teeth
- Ageing
- Trauma
- Medications (tetracycline)
- Fluorosis
- Hypoplasia or hypomineralisation
- Amelogenesis imperfecta
- Erosion and abrasion
what are extrinsic indications for veneers?
Staining not amenable to bleaching
how to do a veneer prep?
use
- putty index
- depth cuts
cervical reduction
- 0.3mm
- slight chamfer margin
- within enamel
- supraginigval or slightly subginigval
midfacial reduction
- 0.5mm
- within enamel
incisal reduction
- 1-1.5mm
what are veneer prep types?
- feathered incisal edge
- incisal bevel
- intra-enamle (window)
- overlapped incisal edge
what is minimal prep technique for veneers called?
gurel technique
what is alternative to veneers?
No treatment
Micro-abrasion
Penetrative resin restorations – e.g., ICON
Direct composite restorations
Crowns
what are the clinical stages of indirect restorations?
- preparation
- temporisation
3.impressions and registration - cementation
- success of each stage dependant on preceding stage
what are these veneer prep types
- what to cement veeners with?
- what do you have to do before cementing?
- Adhesive systems
o NX3 (Nexus)
o ABC
o RelyX Unicem
- Adhesive systems
- Matrix strip or PFTE interproximal surfaces
- Remove excess
o When cement not set
o Microbrushes
- Remove excess
- Matrix strip or PFTE interproximal surfaces
what to cement ceramic onlays/inlays?
- Adhesive systems
o NX3 (Nexus) - ABC
- RelyX Unicem self adhesive resin cement- Self etching, self priming resin based adhesive system
what to cement gold onlays/inklays?
- AquaCem
- Panavia
- RMGI (RelyX)
