Inlays and Onlays Flashcards
what are indirect restorations?
Restorations made outside the mouth in a lab.
name examples of indirect restorations. (5)
Crowns Post and cores Brides work Inlays/onlays Veneers
what are inlays?
Intracoronal restorations made in a lab - Like fillings made outside the mouth
what types of inlay materials are available? (4)
Gold
Composite
Porcelain
Ceramic
when are inlays used? (4)
Used for occlusal or DO/MO
Narrow MOD only - use onlay for normal MODS
Used to replace failing direct restorations (placed once/twice)
Can use as minor bridge retainers - not recommended
in those with low caries risk
what teeth are inlays used on?
molars & premolars
what are the advantages of inlays?
- Can use better materials
- Precisely fitted to margins
= Increased longevity
what are the disadvantages of inlays? (2)
Take longer to create
Increased cost
describe the tooth preparation required fir inlays. (8)
flat pulpal floor
retentive features; isthmus, dovetails and grooves
rounded internal line angles
shoulder/chamfer margins
clear contact points - interproximal and occlusal
no undercuts
4-6 degree taper on walls
proximal box if required
what is the difference between an inlay and an onlay?
Similar but onlays have cuspal coverage
what are onlays? (3)
Extra-coronal restorations made in a lab.
They are similar to inlays only they have cusp coverage.
Less destructive alternative to crowns
when are onlays used? (1) give examples (4)
When there is substantial tooth loss - esp lost cusps - with little/weak remaining tooth structure
Tooth wear cases
Fractured cusps
Root treated teeth
Replace failed direct restorations
what types of onlay materials are available? (4)
Gold
Compose
Porcelain
Ceramic
when are onlays used instead of amalgam? (2)
when;
Higher strength materials required
There is significant reshaping of the tooth required
when is it recommended that you check occlusion and adjust occlsuion in a ceramic onlay?
Ceramic onlays are weak before cementation
So cement them then check the occlusion.
Adjust occlusion once the Onlay is cemented
describe the tooth preparation required for onlays.
significant cusp reduction
flat pulpal floor
retentive features; isthmus,
shoulder/chamfer margins
rounded internal line angles
clear contact points - interproximal and occlusal
no undercuts
4-6 degree taper on walls
proximal box if required
list the clinical stages for the 1st indirect restoration appointment. (7)
Give LA (if tooth is vital)
Made reduction template
Take and impression for the temporary
Carry out tooth preparation
Make the temporary
Take impressions, bite registration and record shade
Cement the temporary
list the clinical stages for the 2nd indirect restoration appointment. (6)
Remove the temporary
Isolate, clean and dry the prepared tooth
Try in, assess fit, adapt and check occlusion
Address any problems now
Cement
Make minor adjustments
what are the alternative to inlays/onlays? (3)
Large direct restorations using amalgam, composite or GI
Crowns - Full crowns, 3/4 crowns (gold)
Extraction
list the types of materials used in veneers. (3)
Porcelain,
Composite
Gold
(Gold palatal veneers for wear cases.)
what are the indicators for use of veneers? (7)
Improve aesthetics
Change teeth shape/contour
Correct peg shaped laterals
Reduce proximal spaces
Align labial surfaces of outstanding teeth
Mask enamel defects - hyperplasia/flurosis
Mask discolouration
what are contraindications for veneers? (8)
Poor OH
High caries rate
High lip lines
Gingival recession
Root exposures
If extensive prep is required - aim to bond veneers to enamel (have to bond to dentine = crowns)
Rotated, overlapping might require extensive prep = crowns better option
Extensive tooth surface loss = dentine exposed (want to bond veneers to enamel)
Heavy occlusal contact = likely to fracture
describe the tooth preparation required for veneers. (3)
cervical reduction = 0.3mm within enamel
midfacial reduction = 0.5mm within enamel
incisal reduction = 1-1.5mm
name the types of incisal edge preparations for veneers. (4)
Feathered incisal edge
Incisal bevel
Intra-enamel window
Overlapped incised edge
list the clinical stages for the 1st veneer appointment.
Give LA if required
Make putty index
Take and impression for the temporary
Carry out tooth preparation
Make the temporary
Take impressions, bite registration and record shade
Cement the temporary
(if no tooth prep required skip to taking the impressions etc)
list the clinical stages for the 2nd veneer appointment.
Remove the temporary
Isolate, clean and dry the prepared tooth
Try in, assess fit, adapt and check occlusion
Address any problems now
Cement
what are alternatives to veneers? (6)
Spot bonded composite No treatment Bleaching/tooth whitening Micro-abrasion Direct composite restorations Crowns
