BDS3 Treatment planning - Inlays, Onlays and Veneers

Question 1

what do you use for mounted study modelS?

Answer 1

Semi- or fully adjustable articulator

Question 2

What are the conventional clinical stages for indirect restorations

Answer 2

o 1) Preparation
o 2) Temporisation
o 3) Impressions and occlusal records
o 4) Cementation

Question 3

what do you use for chairside indirect restorations?

Answer 3

CAD-CAM
- milled from block of ceramic

Question 4

diff between inlay and only?

Answer 4

both made in lab
- inlay intra coronal rest onlay extra coronal rest

Question 5

what are some types of inlays and onlays?

Answer 5

 Gold
 Composite
 Porcelain

Question 6

what are some uses of inlays?

Answer 6

 Occlusal cavities
 Occlusal/interproximal cavities
 Replace failed direct restorations

Question 7

what are some indications of inlays?

Answer 7

 Premolars or molars
 Occlusal restorations
 Mesio-occlusal or disto-occlusal restoration
 MOD
* If kept narrow
o If not – consider onlay
 Low caries rate

Question 8

advantages of inlays?

Answer 8

 Superior materials and margins
 Won’t deteriorate over time

Question 9

disadvantages of inlays?

Answer 9

 Time
 Cost

Question 10

how to do an inlay prep for ceramic and gold?

Answer 10

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

Question 11

alternative to inlays?

Answer 11

• Direct temporary materials
  o Kalzinol (ZOE)
  o Clip (a composite based material)
  o GI

Question 12

why do you not check occlusion of ceramic inlays?

Answer 12

weak when not cemented and may fracture

Question 13

indications for onlays?

Answer 13

 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

Question 14

when are Cast metal inlays/onlays preferable to amalgam?

Answer 14

 Higher strength needed
 Significant tooth recontouring required

Question 15

uses of onlays?

Answer 15

 Tooth wear cases
* Increase OVD
 Fractured cusps
 Restoration of root treated teeth
 Replace failed direct restorations

Question 16

how to do an onlay prep for porcelain and gold?

Answer 16

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

Question 17

alternatives to inlays and onlays?

Answer 17

o Large direct restorations
o Crowns

o Extraction

Question 18

what is a laminate veneer?

Answer 18

A laminate veneer is a thin layer of cast ceramic that is bonded to the labial or palatal surface of a tooth with resin.

Question 19

types of veneer?

Answer 19

 Ceramic
 Composite
 Gold

Question 20

what are some intrinsic indications for veeners?

Answer 20

• Non-vital teeth
• Ageing
• Trauma
• Medications (tetracycline)
• Fluorosis
• Hypoplasia or hypomineralisation
• Amelogenesis imperfecta
• Erosion and abrasion

Question 21

what are extrinsic indications for veneers?

Answer 21

Staining not amenable to bleaching

Question 22

how to do a veneer prep?

Answer 22

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

Question 23

what are veneer prep types?

Answer 23

• feathered incisal edge
• incisal bevel
• intra-enamle (window)
• overlapped incisal edge

Question 24

what is minimal prep technique for veneers called?

Answer 24

gurel technique

Question 25

what is alternative to veneers?

Answer 25

 No treatment
 Micro-abrasion
 Penetrative resin restorations – e.g., ICON
 Direct composite restorations
 Crowns

Question 26

what are the clinical stages of indirect restorations?

Answer 26

1. preparation
2. temporisation
   3.impressions and registration
3. cementation

• success of each stage dependant on preceding stage

Question 27

what are these veneer prep types

Answer 27

Question 28

1. what to cement veeners with?
2. what do you have to do before cementing?

Answer 28

1. • Adhesive systems
     o NX3 (Nexus)
     o ABC
     o RelyX Unicem
2. • Matrix strip or PFTE interproximal surfaces
     
     • Remove excess
       o When cement not set
       o Microbrushes

Question 29

what to cement ceramic onlays/inlays?

Answer 29

• Adhesive systems
  o NX3 (Nexus)
• ABC
• RelyX Unicem self adhesive resin cement- Self etching, self priming resin based adhesive system

Question 30

what to cement gold onlays/inklays?

Answer 30

• AquaCem
• Panavia
• RMGI (RelyX)