Inlays, Onlays and Veneers Flashcards
What are the clinical stages of indirect restorations?
Preparation
Temporisation
Impressions and occlusal records
Cementation
What are inlays?
Intra-coronal restorations made in the lab
A filling made outside the mouth
What are the different types of inlays?
Gold
Composite
Porcelain
When are inlays used?
Occlusal cavities
Occlusal/interproximal cavities
Replace failed direct restorations
Minor bridge retainers - no longer recommended
What are indications of using inlays?
Premolars or molars
Occlusal restorations
Mesio-occlusal or disto-occlusal restorations
MOD - if kept narrow - if not consider onlay
Low caries rate
What are the advantages of inlays?
Superior materials and margins
Won’t deteriorate over time
What are the disadvantages of inlays?
Time
Cost
What tools are needed for inlay preparation?
Handpiece
Burs
Enamel hatchets
Biangle chisel
Gingival margin trimmers
What should be written on an inlay/onlay lab card?
Lab prescription - pour impressions
Mount casts - articulator, waxbite, occlusal record, facebow
Construct restoration - Tooth (FDI), material, thickness, shade, characteristics
What are onlays?
Extra-coronal restorations made in lab
Like inlays but with cuspal coverage - heights of cusps need to be reduced during preparation
What are the types of onlays?
Gold
Composite
Porcelain
What are the indications of using onlays?
Sufficient occlusal tooth substance loss - buccal and/or palatal/lingual cusps remaining
Remaining tooth substance weakened - caries, pre-existing large restoration - MODs with wide isthmuses
When should cast metal inlays and onlays be used over amalgam?
Higher strength needed
Significant tooth recontouring required
What are the uses of onlays?
Tooth wear cases - increase OVD
Fractured cusps
Restoration of root treated teeth
Replace failed direct restorations
Minor bridge retainers (not recommended)
A less destructive alternative to crowns
What happens in the first appointment for inlays and onlays?
LA (if no RCT)
Make reduction template
Impression for temporary
Tooth preparation
Make temporary
Impressions, bite registration and record shade
Cement temporary