Dental Inlays and OnlaysDental inlays and onlays are restorative techniques used to repair moderate tooth damage or decay. Your dentist may recommend an inlay or onlay when a tooth is too damaged to repair with a traditional filling but not damaged enough to require a dental crown.

Unlike traditional fillings, inlays and onlays offer a more precise and durable solution that can withstand the test of time. Not only are these restorations custom-made to match your natural teeth, but they also provide added support for weakened teeth.

These custom-made restorations, also known as indirect fillings and partial crowns, are fabricated in a specialized dental laboratory and then bonded to the affected tooth by your dentist.

Dental inlays and onlays are restorative options for posterior (back teeth) such as premolars and molars. Inlays and onlays and are not options for front teeth such as canine and incisors.

What are Dental Inlays?

A dental inlay is a custom-made restoration designed to repair damage to the area between the cusps of a tooth. Unlike traditional fillings, an inlay is precisely fitted to the prepared cavity like a puzzle piece without extending beyond the cusps of the affected tooth.

What are Dental Onlays?

Dental onlays are similar to dental inlays, but they cover a larger portion of the affected tooth, making them a suitable option for cavities or damage that extends to the cusps of the tooth. Like dental inlays, onlays are designed to fit precisely to the damaged area of the tooth for optimal protection and restoration.

A Comparison of Inlays, Overlays, Fillings, and Crowns

Inlays, onlays, fillings, and crowns are crucial for repairing damaged teeth and preventing further decay while restoring tooth strength and function. But while these techniques serve similar purposes, key differences set them apart. 

Some of these differences include the following:

Dental Inlays vs. Dental Fillings

Dental fillings and inlays serve different purposes in restorative dentistry. Fillings are best for small cavities and minor tooth damage, while inlays are recommended for larger cavities that are not extensive enough to require a dental crown. 

For this reason, inlays are made from more durable materials such as gold and porcelain. In contrast, dental fillings are often made of metal amalgams and composite resin for affordability and ease of placement. 

While dental fillings are a popular choice due to their relative durability and affordability, they are more susceptible to wear and tear over time compared to dental inlays.

Dental Onlays Vs. Dental Crowns

Dental onlays and crowns are restorative procedures for treating extensive tooth damage or decay. While onlays are designed to repair damage on the chewing surface of a tooth, dental crowns cover the entire tooth down to the gumline.

Only a small amount of healthy tooth structure is removed before placing the onlay. Conversely, dental crowns may require more extensive preparation, which can involve a significant reduction of the affected tooth to ensure a proper fit.

How Do Dental Inlays and Onlays Work?

Typically, placing dental inlays and onlays involves two appointments, although the procedure may vary based on individual circumstances. The first appointment involves the initial consultation and tooth preparation, while the second appointment focuses on the dental inlay or onlay placement.

Here's what you can expect during an inlay or onlay procedure:

The First Appointment

Initial Consultation

Before recommending an inlay or onlay prosthetic, your dentist will thoroughly examine the affected tooth and your oral cavity during a consultation appointment. 

Using specialized tools and techniques, your dentist will assess the damage to the affected tooth and surrounding gums and evaluate the underlying bone structure. This may include taking dental X-rays to obtain a more detailed view.

If the examination reveals any underlying issues, such as extensive tooth decay or gum disease, your dentist will recommend addressing these concerns before proceeding with the dental restoration procedure. 

However, if there are no underlying issues, your dentist will discuss the benefits and potential drawbacks of inlays and onlays and address any concerns you may have about the procedure.

Tooth Preparation

Once your dentist has reviewed the examination results and determined that an inlay or onlay is the best treatment option, they will prepare the affected tooth. Before the procedure begins, your dentist will administer a local anesthetic to ensure your comfort and alleviate any pain or discomfort during the tooth preparation.

Once the surrounding gums are numb, your dentist will carefully remove any decay or damage from the affected tooth and existing dental fillings to make space for the inlay or onlay. They will then shape the cavity to precise parameters, using a dental drill to create a snug fit for the inlay or onlay.

Impression Taking

Next, your dentist will take an impression of the affected tooth using dental putty. They will position a dental tray containing the putty over your teeth and ask you to bite down for a few minutes. The dentist then carefully examines this impression to ensure it accurately captures all necessary details before being sent to a dental laboratory to fabricate your inlay or onlay.

Alternatively, your dentist may use a digital scanner to create high-quality 3D impressions of the affected tooth, which are used in computer-aided manufacturing (CAM) to create the custom restoration.

In addition, if you choose a ceramic inlay or onlay, your dentist will recommend restorative shades that match your natural teeth, ensuring a seamless and natural-looking restoration.

Temporary Restoration Placement 

Your dentist will apply a temporary filling to seal the cavity and safeguard your tooth from further damage while your inlay or onlay is fabricated. This protective measure prevents further damage and reduces sensitivity to hot and cold liquids, ensuring you remain comfortable while you wait for your custom restoration.

The Second Appointment

Final Restoration Placement

Your dentist will schedule a follow-up appointment once your custom-made inlay or onlay is ready. During this visit, they may administer a local anesthetic to ensure your comfort, particularly if you experience dental anxiety.

After removing the temporary restoration, your dentist will carefully assess the placement site for any issues. They will then clean the tooth and use an etching solution to create a rough surface for the bonding material.

Before placing the inlay or onlay, your dentist will thoroughly examine it to ensure it fits seamlessly into the affected tooth and matches the natural shade of your other teeth. Once satisfied, they will apply a bonding agent such as resin cement to the tooth and securely place the final restoration.

To complete the process, your dentist will use a curing light to harden the dental cement and ensure the restoration is firmly in place.

Benefits of Inlays and Onlays

Durability

Dental inlays and onlays are popular for restorative dental work because of their durability and ability to withstand significant chewing forces. These custom-made restorations are composed of materials such as gold, ceramic, porcelain, composite resin, and zirconia, allowing for long-lasting use without frequent replacements. 

Furthermore, inlays and onlays cover a larger surface area than traditional dental fillings, providing increased wear and tear resistance. This unique feature makes them an excellent option for patients looking to strengthen their teeth and prevent future damage.  

Aesthetic Appeal

Dental inlays and onlays have become increasingly popular in cosmetic dentistry due to their ability to be customized to match the shape and color of your natural teeth. 

Porcelain inlays and onlays, in particular, can be polished to create a surface that closely mimics your tooth enamel's natural look and feel while also providing superior resistance against staining and discoloration.

Minimally Invasive

One of the significant advantages of dental inlays and onlays is the preservation of natural tooth structure. Unlike dental crowns, inlays and onlays require removing only the decayed or damaged portion of the affected tooth, resulting in a minimally invasive procedure that helps maintain the tooth's structure, increasing its lifespan and reducing the risk of fracture or breakage.

Comfort

Dental inlays and onlays offer a more comfortable alternative to traditional amalgam fillings. Materials such as porcelain used to create inlays and onlays are biocompatible, making them an excellent option for those with allergies to metals commonly found in amalgam fillings.

In addition to their biocompatibility, the materials used in inlays and onlays expand and contract at a similar rate when exposed to temperature changes allowing for a more natural feel in your mouth.

Dental Inlays Vs. Dental Onlays: What's the Difference?

Although inlays and onlays serve a similar purpose, there are some key differences between the two restorative dental treatments. 

These differences include the following:

  • Size: Dental inlays and onlays offer two different solutions for repairing damaged teeth. Inlays are designed to address damage that is confined to the chewing surface of the tooth, while onlays are a larger restoration used to repair damage that extends beyond the chewing surface and includes the cusps of the tooth
  • Strength: Although dental inlays are known for their strength and durability, they may not be the best option for teeth subjected to significant chewing force, especially considering their smaller size. Conversely, dental onlays are generally a stronger option than inlays as they cover a larger area of the tooth and extend over the cusps, providing added protection and strength where it is needed most
  • Preparation: While the preparation process for dental inlays and onlays is similar, the size difference between the two restorations requires a slight variation in technique. In the case of onlays, more of the tooth structure needs to be removed to accommodate the larger size of the restoration
  • Cost: Due to the additional time and materials required for fabrication and placement, onlays are generally more expensive than inlays.

Who Is a Good Candidate for Dental Inlays and Onlays?

Because of their versatility, dental inlays and onlays are suitable for multiple restorative purposes. If you experience any of the following dental issues, dental inlays and onlays may be suitable treatment options.

  • Cracked or fractured teeth: Inlays and onlays are an excellent restorative option for cracked and fractured teeth due to their minimally invasive placement procedure. This means the surrounding healthy tooth structure can be preserved while restoring the damaged tooth.
  • Moderate to severe tooth decay: Inlays and onlays are ideal solutions for repairing cavities that are too large for traditional fillings but not severe enough to warrant a dental crown. By fitting precisely into the cavity and creating a tight seal, inlays and onlays can help restore the tooth's natural function and protect it from further decay or damage.
  • Discolored and misshapen teeth: Dental inlays and onlays can be customized to perfectly match the shape and shade of your natural teeth, making them an effective cosmetic dentistry solution for enhancing the appearance of your smile.
  • Weakened teeth: If you have weakened teeth unsuitable for invasive dental prosthetics like crowns, inlays, and onlays may be an excellent option for preserving your natural tooth structure. These custom-made restorations can help strengthen and protect your teeth without the need for more extensive procedures, providing a minimally invasive alternative to traditional dental prosthetics.

Dental inlays and onlays are versatile restorative treatment options for damaged or decayed teeth, offering both functional and cosmetic benefits. These custom-made restorations are designed to preserve the natural tooth structure as much as possible while providing added strength and durability. 

Compared to traditional fillings, inlays, and onlays offer a longer lifespan and are less invasive than dental crowns. Inlays and onlays may be the perfect solution if you are looking to improve your dental health and enhance your smile.

To learn more about these treatments and whether they suit you, contact our office today to schedule a consultation.

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