inlays

Question 1

inlays indications

Answer 1

replace failed direct Rxs
premolars/molars
MO/DO Rxs
MOD if narrow (if not onlay)
low caries rate

Question 2

inlays contraindications

Answer 2

active caries and PDD
time
cost

Question 3

inlays definition

Answer 3

intracoronal restorations made in lab, not spilling out over cusps, encased within a cavity
- fillings made outside mouth

Question 4

inlays types

Answer 4

composite
gold
ceramic

Question 5

inlays conventional clinical stages

Answer 5

preparation
temporisation
impressions and occlusal records
cementation

Question 6

inlays advantages over direct

Answer 6

superior materials and margins
- gold probably best material you can get for a marginal finish
less chance of deterioration over time

Question 7

inlays ceramic/composite prep

Answer 7

Butt joint CSMs
isthmus 1.5-2mm
no bevels at occlusal aspect - thin porcelain fractures
flat pulpal floor, even depth - perpendicular to PofI, improves retentive form
(supragingival) shoulder or chamfer margins
rounded internal LAs
clear of adjacent tooth contact points
4-6 degree tapered walls - no UCs
margins clear of occlusal contact points

Question 8

inlays gold prep

Answer 8

isthmus 1mm
margins clear of occlusal contact points
flat pulpal floor
- even depth, perpendicular to PofI
4-6 degree tapered walls, no UCs
15-20 degree bevel upper 1/3 of isthmus wall
clear of adjacent tooth contact points
occlusal key/dovetail
(supragingival) shoulder or chamfer margins
if proximal box required - keep margins clear of adjacent tooth contact points
consider internal accessory retention features e.g. grooves
rounded internal line angles

Question 9

inlays gold prep - occlusal key/dovetail

Answer 9

will be cementing in with GIC so gives some mechanical retention
don’t need for ceramic/composite as will be cementing in with composite resins (get more chemical retention)

Question 10

inlays temporisation and impression

Answer 10

make temp Rx
 - always make first before doing impression
impressions and occlusal records
 - polyether/impregum
 - to lab
fit temp Rx

Question 11

inlays alternative temps

Answer 11

direct temp materials
- but remember you need to cut back out, might accidentally modify cavity then your inlay won’t fit
kalzinol (not recommended) - causes collagen fibres in D to collapse so won’t get such a good bond when using composite resin
clip
GI

Question 12

inlays lab prescription

Answer 12

pour impressions
mount casts on articulator
 - wax bite/occ record
 - FB - particularly if you are changing the guidance or significantly changing occlusion etc
construct Rx
 - tooth
 - material
 - thickness
 - shade
 - characteristics - fissure patterns, staining, disguise tooth as another tooth e.g. an E as a 5

Question 13

inlays cementation

Answer 13

ceramic - weak when not cemented - don’t check occlusion before cementation as may fracture
- adhesive systems: resin cements to give strength
gold inlays
- often use GI but can use resin cements as well
place matrix strips IP or PTFE tape over adjacent teeth

Question 14

inlays alternatives

Answer 14

large direct Rx
 - amalgam, composite, GI
crowns
 - 3/4 gold - not quite down to gingival margin
 - full
extraction