How a Cosmetic Dentist Can Place Inlays and Onlays

A cosmetic dentist can use inlays and onlays in situations where a crown might be undesirable or unnecessary. Inlays strengthen the tooth's existing structure, and onlays cover the cusp of the tooth. Both are bonded on to restore tooth integrity and functionality in a natural-looking way.

The similarities and differences between inlays, onlays, and crowns

Inlays and onlays achieve many of the same results as crowns, to the extent that they are sometimes referred to as partial crowns. All these types of tooth restoration strengthen damaged teeth and look natural, but inlays and onlays differ from crowns in a few key ways.

Restoration method

Crowns cover the entire tooth to the gum line and can be used to cap teeth that have suffered extreme damage or even as replacements for missing teeth. Inlays and onlays are placed, respectively, in or on the existing tooth. Patients can be recommended these treatments as an alternative to crowns if the tooth structure is still intact. Both procedures restore full functionality and appearance to a patient's tooth, but the crown covers the tooth entirely whereas inlays and onlays work with the existing tooth structure.

Materials

Inlays and onlays can be made of a variety of materials, including gold, ceramic, porcelain, or resin, the same as crowns. In the past, gold crowns and inlays were more common, but nowadays most patients opt for porcelain, resin, or ceramic. These materials can be colored to look indistinguishable from a patient's natural teeth. They are also very durable, lasting for years at a time, and require no more maintenance than regular teeth.

Preparation

Inlays, onlays and crowns all require a thorough examination and cleaning of the patient's teeth. This involves the removal of decay as well as any weak part of the tooth. Crowns have specific requirements in this regard because they have a minimum thickness. After this step the cosmetic dentist will have a good idea of the state of the tooth and will move on to taking impressions. A bite registration is also recorded so the dentist can know how the patient's teeth are aligned.

Procedure

The procedure for inlays, onlays, and crowns is very similar. Many cosmetic dentists have a milling machine in the office that can mill all three pieces. This allows for single-visit restorations. At an appointment, pictures are taken for the CAD/CAM milling machine. Then the piece is milled on site quickly enough for the cosmetic dentist to bond it before the patient leaves.

If an office does not have a milling machine, the patient can make two visits. During the first, pictures are taken, and a second appointment is scheduled after the new inlay, onlay, or crown arrives from the lab. In this case the patient is fitted with a temporary crown in between visits.