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INLAY ONLAY

INLAYS & ONLAYS

What is Inlays and Onlays:

Inlays and Onlays are indirect dental restoration that have been designed to restore large cavities caused by carries,or trauma. Additionally,root canal-treated teeth with sufficient remaining tooth structure could also be selected for these restoration.As for these large cavities,especially when there is cuspal coverage involved,it may be less predictable to be restored with normal direct fillings ( amalgam or resin ). As a result, the obvious advantages of Inlays/Onlays over those direct fillings is their strength.Moreover,when compared to crown preparations,Inlays/Onlays preparation are much more conservative because of tooth structure preservation.However,like other indirect restoration,Inlay/Onlays require at least “two clinical visit” to finish the procedure. 

Step-by-step for Inlay / Onlays:

  1. Old restoration and remaining decay removed. Final tooth preparation.
  2. Impression and inlays/onlays fabrication in the laboratory.
  3. Inlays/Onlays delivery on the second visit.

Materials for Inlay / Onlay:  

1.Metal: 

High gold alloys(type II or type III) are the most common alloys for inlay/onlay fabrication due to many good qualities. Bio-compatibility and good margin adaptation are among them. When compared to resin or ceramic, metal restorations are much stronger (not likely to break). Moreover, gold alloys are less abrasive than ceramic materials when used against dental enamel.

2.Tooth-colored materials; Composite resin and ceramics: 

This type of materials is popular for their esthetics. A variety of shades can be selected to mimic tooth structures.

2.1 Composite Inlays/onlays:

This is basically an indirect technique for composite resin restorations. The inlays/onlays are made in the laboratory instead of directly on the tooth, as a result, contacts and contours can be more properly fabricated. Furthermore, sensitivity from polymerization shrinkage caused by direct resin filling is eliminated due to no light curing of composite resin on the tooth. However, since composite resin has limitations and tends to break more easily than ceramic materials, it is still much less popular compared with ceramic materials when it comes to ‘tooth-colored inlays/onlays’.

2.2 Ceramic Inlays/onlays:

Even though they are made of ‘ceramic materials’ which also known for the ability to break, many reinforcement techniques have been developed to enhance the strength of these materials and eventually become optimal for normal functions in posterior teeth. This is the major advantage of ceramics over composite resin. However, patients with para-functions such as night-grinding or clenching may not be suitable for these materials, metal alloys will have to be selected for better longevity of the restorations.

Treatment time:

Normally, it will take around 2 visits (3-5 days)  to complete the treatment.

 

FAQ

 
    A:New dentures may feel a little odd or loose for a few weeks until the muscles of the cheeks and tongue learn to keep them in place and you get comfortable inserting and removing them. Also, it is not unusual for minor irritation or soreness to occur and for saliva flow to increase when you first start wearing dentures, but these problems will diminish as the mouth adjusts.
    A:Dentures are made to closely resemble your natural teeth so there should be only a small noticeable change in appearance. In fact, dentures may even improve your smile and fill out your facial appearance.
    A:Eating with new dentures will take a little practice and may be uncomfortable for some wearers for a few weeks. To get used to the new denture, start with soft foods cut into small pieces. Chew slowly using both sides of your mouth. As you get used to new dentures, add other foods until you return to a normal diet. Be cautious with hot or hard foods and sharp-edged bones or shells. And, avoid foods that are extremely sticky or hard. You should also avoid chewing gum while you wear the denture. Also, don’t use toothpicks while wearing dentures.

A:After getting dentures, you may have difficulty pronouncing certain words. If so, practice by saying the difficult words out loud. With practice and with time you will become accustomed to speaking properly with dentures.

If dentures “click” while you’re talking, contact your dentist. Dentures may occasionally slip when you laugh, cough, or smile. Reposition the dentures by gently biting down and swallowing. If any speaking problem persists, consult your dentist or prosthodontist.

A:Your dentist or prosthodontist will instruct you as to how long to wear dentures and when to remove them. During the first several days after receiving your denture, you may be asked to wear it all the time, including while you sleep. Although this may be temporarily uncomfortable, it is the quickest way to identify the areas on the denture that may need adjustment. Once adjustments are made, you should remove dentures before going to bed.

This allows gum tissues to rest and allows normal stimulation and cleansing by the tongue and saliva. The denture can be put back in the mouth in the morning.

    • A:A denture adhesive may be considered under the following circumstances:

1. To enhance satisfaction with a properly constructed denture. Adhesives enhance retention, stability, bite force, and an individual’s sense of security.

2. To assist individuals with dry mouth conditions that lessen denture adherence, such as individuals taking cold medications, those with neurologic disabilities including strokes, and the elderly.

3. To provide added stability and security for those who place unusual demands on facial muscles, such as public speakers or musicians.

A:There are situations when denture adhesives should not be used. Those cases include:

1. When it is used as a “fix” for ill-fitting or poorly constructed dentures. If dentures begin to feel loose, cause discomfort or cause sores to develop, contact your dentist as soon as possible.

2. When a dentist has not evaluated dentures for a long time. Dentures rest on gum tissue and the jawbone, which shrink and deteriorate, respectively, over time. Therefore, the real problem might be a need for a denture adjustment or new dentures.

3. When oral hygiene practices cannot be sustained.

4. When adhesives have been used for a long time, especially when visits to the dentist are infrequent, and when the frequency and volume of the adhesive use increases. These developments may indicate the need for a denture adjustment or new dentures.

5.When any known allergy exists to the adhesive’s ingredients.

A:Here are some tips to consider when applying denture adhesives:

  • Use the minimum amount necessary to provide the maximum benefit. Apply less than you think you need, and then gradually increase the amount until you feel comfortable.
  • Distribute the adhesive evenly on the tissue bearing surface of the denture.
  • Apply or reapply when necessary to provide the desired effect.
  • Always apply the adhesive to a thoroughly clean denture.
  • Remember adhesives work best with a well-fitting denture.

A: 1.Paste application. Apply this denture adhesive to a dry or preferably wet denture. Avoid placing adhesive close to the denture borders. If the adhesive oozes, use less of the product. For dentures on the upper jaw, apply three short strips of adhesive — or a series of small dots — along the ridge area and one down the center. For dentures on the lower jaw, apply three short strips of adhesive — or a series of small dots — in the center of the ridge area.

2.Powder application. Sprinkle a thin, uniform layer throughout the tissue-bearing surface of the denture. Shake off excess powder and press the denture into place. Powders may be preferred over pastes because they are easier to clean off the denture and tissue. In addition, they don’t have the same tendency as pastes do to “shim” (keep the denture away from the tissue).

    A:Dental adhesives are safe as long as they are used as directed. If the denture is well-fitting and the adhesive is only used to give added stability, there should be no ill effects. If adhesives are used excessively to fill voids for an ill-fitting denture, they can be harmful to the underlying soft and hard tissues. Occasionally, in these cases, inflammation of the soft tissues can result. In addition, because of its movement on the soft tissue and underlying bone, an ill-fitting denture can cause bone loss.

A.For healthy patient without systemic disease and no pathology of the edentulous site,in some case implant could be placed immediately and in some cases,implant could be place after 6-8 weeks of extraction to allow soft tissue healing.For those with pathology in the bone which cause bone defect or in case of infection in the area of future placement,usually the waiting time is longer,around 3-4 months after extraction.

Please note that the timing and treatment planning will be discussed with patient on a case by case basis.

    A.It is possible to have implant placed but it might need bone graft to reconstruct the bone for implant placement.Also alternative treatments such as bridges or other types of prostheses can be an option.
    • A.

1.Uncontrolled diabetes which affect wound healing.

2.Uncontrolled high blood pressure.

3.Ostoporosis patient who receive Biphosphonate intravenous more than 3 years.

4.Cancer in craniofacial area which currently has radiotherapy.

5.Heavy smoker especially 20 cigarette/day.Smoking cessation should be done before treatment.

6.Pregnant patient should delay the treatment.

7.Patient who take anticoagulant or patient who has a history of stroke within 6 mo’s-1 year should consult physician before treatment.

8.Patient who takes immune suppresant should consult physician.

9.Patient with liver disease which lead to unstop bleeding should consult physician.

    • A.Any infection in the oral cavity should be removed before implant treatment to avoid the risk of infection at the implant site and to failure of the implant.

1.Periodontitis – should be treated before placing an implant since patient with history of periodontitis has higher risk of implant failure.

2.Caries – infected tooth structure should be removed to reduce oral cavity germ

3.Endodontics – root canal treatment should be done since apical infection especially adjacent to the site in the bone can infect the implant site.