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DEN304 - IODC > Inlays and Onlays > Flashcards

Inlays and Onlays Flashcards

1
Q

Inlay and purpose

A

Intracoronal restoration strengthen and repair decayed or damaged posterior teeth

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2
Q

Onlay and purpose

A

Similar but extends over weakened cusps to provide extra protection

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3
Q

Indication for inlay and onlays

A

alternative to amalgam - toxicity and lichen planus

resin not indicated due to size of cavity/prev failure/aesthetics

Long lasting aesthetic result aim

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4
Q

Indications for inlay

A

Low caries rate
Small MO/DO cavities in molars premolars
Conservative MOD in molars

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5
Q

Indications for onlay

A

Teeth with larger restorations and sound buccal and lingual walls
Endo treated teeth due to risk of fracture
Wider MODs
MODs in premolars

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6
Q

Materials for inlays and onlays

A

Gold
Ceramic
Resin composite

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7
Q

Advantages of gold

A 
Conservative
Marginal integrity 
Good wear
Corrosion resistance
Easy to handle
Excellent physical and mechanical problems
Excellent survival rates
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8
Q

Consideration for gold

A

Cost
Technique Sensitivity
Poor aesthetics
Wedge effects of inlay - creates wedge

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9
Q

Advantages of adhesive technologies

A

Very aesthetic
Stronger more stable -no wear or discolouration
Less shrinkage as resin composite is used as luting agent
Marginal leakage is minimal
Conservative ceramic restorations

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10
Q

Ceramic considerations

A

Fragile - handled with care
Can’t make intramural adjustments until bonded
Adjustments can compromise aesthetics
Wearing of luting agents can lead to marginal gaps and secondary caries
Two visits required

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11
Q

Types of ceramic

A

Feldspathic glass
Leucite reinforced
Lithium disilicate

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12
Q

Indirect resin composite types

A

Hybrid composite
Ceromers
Ceramic optimised resins

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13
Q

General rules of preparation

Finishing line should extend to composite

A

Box shaped cavities
Divergent walls to allow path of insertion
No undercuts
limit path of insertion
Resist occlusal forces
Specific guidelines apply for gold or ceramic/composite inlays and onlays
Occlusal isthmus should not exceed 1/4 intercuspal width

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14
Q

Gold inlay

A

2mm occlusal reduction
Proximal box 1mm width
Isthmus 1/3 of intercuspal width

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15
Q

Gold onlay

A

IC prep is same as inlay
1.5-2mm cusp reduction
1mm occlusal shoulder
Has arm which extends to support result of structure

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16
Q

Stress distribution

A

Protection provided over top to equally distribute forces to share stress concentrations

17
Q

Prep for ceramic inlay
Similar to
Cavity shape
Grooves or slot?

What else to check?

A 
Similar to gold inlay no bevels
Box shaped cavity 
Parallel and divergent walls
Round internal line angles to reduce risk of fracturing 
90 degree cavo surface angle 
2mm occlusal depth

No grooves needed as restoration will be bonded
Bevelled finishing lines can create thin areas liable to fracture
Check occlusal contacts
Outline should AVOID occlusal contacts to avoid unnecessary load –> deterioration of cement and marginal openings

18
Q

Prep for ceramic onlay

A

Same as onlay
One or more cusps also prepared
Different prep guidelines for cusp reduction
Block undercuts with GIC, RMGIC, resin composite

19
Q

Equipment
Burs

Bur kits

Gingivae

Provisional

A

Basic set up
Burs = medium grit tapered and straight diamond

Give box shaped cavities
Retraction cord and packer/GRP

Provisional material

20
Q

Temporisation

A

No eugenol as this will affect setting of resin

21
Q

Cementation should be done

A

Under rubber dam as it is sensitive to moisture

22
Q

Aesthetic cementation

A

Resin luting > traditional
Can be self cured or dual cured
Compomers contraindicated due to expansion –> fracture

23
Q

Process of cementing glass ceramic

Surface coated with

Example of cement used

A

Fitted surface must be treated with HF acid/sandblasting -> expands surface for binding

Fitting surface coated with silane coupling agent

Calibra resin cement
Bond between ceramic and tooth is created

24
Q

Composite inlay - resin cement for cementation

Composite cement to composite inlay

A

Roughening of surface is NOT sufficient

Higher rate of failure

25
Q

Cementation process

What also can be used?

Thickness requirements

A

High viscosity resin composite can also be used
Thickness of ceramic >2mm compromises curing of material
Colour of inlay can also affect setting

26
Q

Failure

A

Bulk fracture - often in areas of cusp coverage and at isthmus
Marginal breakdown - quicker wear

27
Q

Contraindications for inlay/onlay

A

Poor OH

Bruxism/excessive occlusal load

28
Q

Gold cementation
Conventional cement options
Resin cement options

A

Zinc phosphate/GIC

Panavia/RelyX

DEN304 - IODC (58 decks)

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