crowns and inlays for posterior teeth Flashcards
how can inlays and posterior crowns protect the tooth from fracture and wear?
by
- controlling loads on teeth
- providing stable occlusal contacts
- protecting axial walls from stress
- protection of teeth in tooth wear cases
basic principles of indirect restorations
caries removal
keep as much sound tissue
maintain pulpal and periodontal health
restore form and function
longevity
aesthetics
occlusal stability
must be cleanable
thorough case assessment
material options for a posterior crown
precious metal
non-precious metal
zirconia
metal ceramic
lithium disilicate
material options for a posterior onlay
precious metal
non-precious metal
zirconia
composite
lithium disilicate
onlay - benefits
less destructive than a crown
provides cuspal coverage
mostly supragingival margins
access for sensibility testing
onlay - downsides
retention/resistance issues
technical challenges
aesthetic limitations
onlay - indications
tooth wear
restoration of some RCT’d teeth
failure of direct restorations
fractured cusps
onlay prep guidelines
even width shoulder
follow the slopes of visible cusps
posterior crown benefits
retention/resistance often better
easier technically
covers all cusps
aesthetically sound (if tooth coloured)
posterior crown downsides
more destructive than an onlay
often sub gingival margins
cannot access for sensibility testing
need a sound crown core
posterior crowns - indications
tooth wear
restoration of heavily restored RCT’d teeth
failure of large direct restorations
fractured cusps
aesthetics
- if tooth coloured
posterior crowns/onlays treatment planning
up to date acceptable radiograph
tooth history
dental disease status
importance of tooth to dentition
tooth restorability
relationship to other teeth
occlusal factors
patient expectations
human factors
- anxiety
- mobility
- costs
medical/social history
treatment planning for failed posterior crowns
manage expectations
basic disease control
- caries
- periodontal disease
assess restorability
RCT’s if needed
