How could discoloured anterior teeth be managed?
- Acid pumice abrasion
- Non-vital bleaching
- Vital bleaching
- Veneers
- Crowns
- Composite
What is an inlay?
Intra-coronal restoration made partly or completely outside the mouth.
What is an onlay?
Intra-coronal restoration made partly or completely outside the mouth with partial or complete cuspal coverage.
What can inlays and onlays be made from?
- Gold alloys (60% gold, 22% silver, 13% copper, 3.5% palladium and zinc and iron) (best for wear and won’t fracture, careful though as if opposing tooth is made from porcelain or ceramic could wear it down)
- tooth coloured material :
1. porcelain fused to metal (PFM)
2. all ceramic
3. Emax (lithium disilicate glass ceramic) (v.strong)
4. zirconium oxide
What are the indications for gold inlays/onlays?
- large restorations
- endodontically treated teeth (onlays only)
- teeth at risk of fracture
- wide open contacts and occlusal plane correction
- subgingival lesions
- prosthodontic abutments
Contraindications for gold inlays/onlays?
- young dentition with large pulp chambers
- aesthetics
- poor OH
- small restoration
Advantages of gold inlays/onlays?
- strength and low wear
- biocompatibility
- control of contours and contacts
Disadvantages of gold inlays/onlays?
-Extensive tooth prep
-cemented restoration, discrepancy and micro leakage
-can have abrasive/splitting force on natural teeth
-appointments and cost
-technique sensitive
galvanic currents
What should the tooth prep be like for gold inlays/onlays?
- undercut free with single path of insertion
- max height with taper of around 10 degrees
Advantage of tooth coloured onlay to gold?
- aesthetics
- less flare of wall required (only 6-10 degree) and margins don’t require bevelling
What imps do you need when doing crowns/onlay?
- silicone of arch you’re working on
- opposing alginate
- bite registration in ICP using hydrobite
What materials could you use to temporise an onlay?
- soft light cured resins (Fermit)
- self cured acrylic resin (Protemp or Maxitemp)
- Telio (light cured) (what I used)
What are the potential failures of inlays/onlays?
- fracture
- secondary caries
