Inlay, Onlay, and Veneers Flashcards
____ restorations:
• Restoration is fabricated outside of the mouth
• Dental impression is taken of the prepared tooth, then
sent to lab or milled in-office
• Includes inlays and onlays, crowns, bridges, and
veneers
Indirect restorations
When margin exceeds 2/3 of the distance between central groove and cusp tip, what do you do?
MUST CAP WEAK CUSPS
When margins end ½ distance between central groove and cusp tip what do you do?
CONSIDER CAPPING WEAK CUSPS
• indirect restoration that is placed within the cusp tips of a
tooth
• offers no protection of the cusp from occlusal forces
INLAY
____ are used for:
•Teeth with minimal caries and strong buccal and lingual cusps
•Acceptable (normal) occlusion
Inlays
• indirect restoration that covers one or more cusps, extending through and
beyond the cusp tip to the facial/lingual and proximal slopes of the covered
cusps
• incorporates the principles and advantages of both intracoronal and
extracoronal indirect restorations
• occlusion in all functional positions is supported by restorative material
rather than tooth structure
ONLAY
EMax Crowns are used for Indirect Restorations and is made of what?
Lithium Discilicate
The following are indications for ______:
•Large carious lesions or existing defective
restorations
•Cracked Teeth
•Endodontically treated teeth
• Must have sufficient tooth structure to retain the onlay
and allow for removal of undercuts
• When enough facial and lingual surfaces are relatively intact; otherwise do a crown
Onlays
when 1/2 way between central groove and cusp tip - consider ____ ___ ____
onlaying the cusp
2/3 way between central groove and cusp tip - SHOULD ____ __ ___
should onlay the cusp
the following are (advantages or disadvantages) of Indirect Restor.
•Strength of materials •Conservation tooth structure •Better control of restoration’s contours
advantages
Do you bevel a Gold Inlay?
YES YOU DO
With _____ Inlay, the following are true:
• Short walls should have a 2° divergence
• Long walls can have a 5-7° divergence
Gold
How deep must the pulpal floor be in a Gold Inlay?
2mm deep
T/F: There is no reverse S in Inlay preps.
true
t/f: Bevels for Gold Inlay Prep • 1.0mm at occlusal • 1.0mm at gingival • Axiopulpal line angles
True!
Bevels
• 1.0mm at occlusal
• 1.0mm at gingival
• Axiopulpal line angles
____– protects enamel from fracturing
Bevel
t/f: there is no gingival bevel on the ceramic Inlay.
true
Does an onlay or inlay have more internal stress?
inlay
T/F: With Gold Onlays, the following is true:
Minimum of 1.5 mm of gold to cover cusps supporting occlusion;
1.0 mm for cusps not supporting occlusion
true
The following is an exception for cuspal coverage of _____ tooth:
Do not cover the facial cusp of maxillary molar or premolar if supported
by strong tooth structure, and in smile line
• Modified “esthetic” coverage of facial cusp if weak
maxillary tooth
the following are indications for _____ Onlays
•Esthetics - areas of esthetic importance for the patient
•Large defects or previous restorations
–Wide labiolingual missing tooth structure
–Teeth that require cuspal coverage
–Contours of large restorations are more easily developed in the
lab
–Indirect materials are more durable than direct for replacing
occlusion and contacts
Porcelain
The following are ______ for Porcelain Onlays:
• Ceramics can fracture if they don’t have sufficient bulk or are under excessive stress
e.g. - in bruxers and clenchers
- Inability to maintain a dry field
- Deep subgingival preparations - difficult to get an impression, difficult to finish, difficult to get good bonding
Contraindication
T/F: the following are advantages of Porcelain Onlays
•Improved physical properties •Wear resistance
• porcelain wears opposing teeth the most and has the most resistance to wear
• porcelain> lab processed composite > direct resin composites in order of
causes most wear and wears the least to causes least wear and wears the
most
•Reduced polymerization shrinkage
• all shrinkage occurs in the laboratory, the only material that can shrink is the resin
composite cement which is used during cementation
true
t/f: during the onlay procedure, it is important that undercuts are blocked out with a glass ionomer liner /base or resin composite.
true
For Porcelain Onlays it requires
____ mm reduction over functional cusps
____ mm reduction over non functional cusps
- 0mm reduction over functional cusps
1. 5 mm reduction over non functional cusps
t/f: you do not bevel Porcelain onlay preps
true
t/f: With Porcelain Onlays:
•Use eugenol-free cement
• Eugenol interferes with bonding •Or, if you must use cement containing eugenol,
important to pumice tooth well to remove eugenol
True
A?
Gingival wall
B?
Axial Wall
C?
Pulpal Wall
D?
Dovetail
E?
Occlusal Bevel
F?
Proximal Walls
NO BEVELS
G?
Gingival Bevel
t/f: Lithium Discilicate and Zirconia are both user friendly and Strong types of Permanent restorative materials.
true
What are the two methods of making veneers?
• Indirect
Most commonly Feldspathic Porcelain or Lithium Disilicate
• Direct
Composite
The following are \_\_\_\_\_\_ for veneers •Severely Malpositioned teeth • Ortho may be indicated •Denuded Dentin •Unavailable Enamel •Poor Oral Hygiene •Beware of highly fluoridated teeth- Issues with bonding • No primary teeth! • Adolescents • Pregnancy •Oral Habits- Bruxism
contraindications
The Following are ____ for veneers
• Intrinsic Discoloration
• Tetracycline staining
• Fluorosis
• Extrinsic Staining
Coffee
Smoking
Wine
• Wear Patterns
• Poor Restorations
• Diastema Closure
• Rotated and Misaligned Teeth
indications
t/f: porcelain is best tooth substitute great for veneers
true
The Following Describes the _____ prep for composite Veneers
- Most often recommended
- Remove only enough tooth structure to achieve optimal contours with final restoration
- Incisal edge remains intact
- Intra-enamel preparation
Window
The Following Describes the _____ _______ prep for composite Veneers
• Preparation includes incisal edge
• Indicated when tooth needs to be lengthened or an incisal defect
is present and needs to be corrected
Incisal Lapping Prep
______ - • Involves use of acidic and abrasive agents applied to enamel surface • 37% phosphoric acid and pumice or 6% hydrochloric acid and silica
Microabrasion
______ - • Removal of enamel defect with bur • 12 fluted carbide or diamond finishing bur, followed by 30 fluted carbide finishing bur • Polished with rubber point
Macroabrasion
t/f:
Porcelain Veneer Procedure
DIAGNOSTIC WAX UP !!!!
Very important to see what can be done for both you and the patient
true
With Veneers there is a __ - __ mm minimum reduction for material bulk. Only if not lengthening the incisal edge.
1-2 mm
Why is it important to use light cured composite cement when placing veneer on tooth?
dual cure is not color stable
T/F: Tack cure in order to clean cemement from margin, before it becomes completely set.
true
T/f: DO NOT OVERHEAT veneers when polishing. Excess heat may cause degradation of cement bond
true
Adjust occlusion ____ (before or after) veneers have been
bonded
• fracture more likely otherwise • use diamond bur and water spray
after
t/f: the following are common mistakes with veneers:
- Failure to address gingival asymmetry
- Failure to do a wax up for the case
- Failure to work with an experienced esthetic ceramist
- Using Ferric Sulfate (Astringedent®) hemostatic agent to stop bleeding around gingiva It will stain margins
- –>Use Aluminum Chloride (Hemodent®) instead
- Improper bonding technique- May lead to black staining
- Failure to communicate effectively with patient
- Starting a case that should have NEVER been started in the first place.
true
