Indirect Restorations
Indirect restorations are also known as porcelain inlays and onlays. Inlays and Onlays can be made of gold, composite of porcelain. However due to esthetic concerns, most are made of porcelain. Porcelain inlays and onlays create fillings that are not only beautiful, and unnoticeable, but also add strength to weakened teeth. Porcelain inlays and onlays are made in a laboratory from oven fired porcelain by a highly skilled laboratory technician. These restorations are esthetically pleasing and very strong once they are placed, thanks to new bonding technologies. They are stronger than bondings and will typically last much longer than direct bondings. Inlays sit inside the tooth like a filling, but instead of being made of composite, they are made of porcelain. We generally choose to do inlays when patients are not cost sensitive and want the work to last as long as possible.
Onlays can be fabricated when at least one cusp (the outer part of the tooth) or more than half of the biting surface is damaged. Many times these teeth would be condemned to crowns in other offices. By restoring the tooth with an onlay instead of a crown, it may be possible to create better periodontal health and esthetics. In addition, because we don’t grind away as much tooth structure as with a crown, it is healthier for the tooth...
Because inlays and onlays are fabricated in a laboratory, they require two appointments to complete. During the first visit the damaged or decaying area of the tooth is removed along with any old filling material, and the tooth is prepared for the inlay or onlay. An impression of the tooth taken, and sent to a lab for fabrication of the restoration... Dr. Breiterman will then create a custom made provisional restoration on the tooth until the next appointment.
At the second appointment, the provisional restoration is removed. Dr. Breiterman will make sure that the inlay or onlay fits correctly. The inlay or onlay will then be bonded to the tooth with a strong resin and polished to a smooth finish.
Considerations
Traditional fillings can reduce the strength of a natural tooth by up to 50%. . As an alternative, inlays and onlays that are bonded directly onto the tooth using special high-strength resins can actually increase the strength of a tooth by up to 75%. As a result, they can improve the longevity of the tooth using the most conservative treatment. In some cases, where the damage to the tooth is not extensive enough to merit an entire crown, onlays can provide a very good alternative.
Advantages of Tooth-Colored Restorations
There are many advantages to tooth colored restorations. Resin fillings are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.
Disadvantages of Silver fillings:
Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split. Silver fillings are also extremely reactive to hot and cold, expanding and contracting with each change in temperature. Imagine eating hot soup and drinking iced tea!
Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums. Every silver filling leaks. This means that harmful bacteria can get beneath your filling, causing further decay to the tooth that it was meant to protect. Many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure.
Fortunately, silver fillings can safely be replaced with new restorations such as tooth colored inlays or onlays.
The result is a beautiful smile!