Dental Fillings (Dental Inlay)
Dental Fillings are a dental treatment restoring the function and structure of a missing tooth and are also supporting dental implants. Dental inlay is an indirect dental filling composed by a material (gold, composite or porcelain) applied to the decayed or fractured tooth.
An inlay is similar to a filling, but it lies within the cusps on the chewing surface of your tooth. An onlay is larger than an inlay. It replaces one or more decayed cusps. Inlays or onlays can be made of gold, composite resin (plastic) or ceramic, porcelain is a very popular choice because of its ability to match the colour of your tooth and its strength.
Who is a good candidate?
The best candidates for inlays and onlays are those
who have experienced major tooth decay or tooth damage and are no longer ideal candidates for dental fillings.
If you have new cavities, or old metal fillings that need to be replaced, inlays and onlays are a durable, natural looking alternative that preserve remaining tooth structure.
There should be enough healthy tooth structure remaining for the inlays to be supported. During the consultation process your doctor will note the extent of the damage to your teeth and determine the most ideal and conservative treatment possible.
How is the procedure performed?
- Numbing the tooth that is to be restored (giving local anaesthetic).
- Taking impressions of the opposing set of teeth so the lab can get the bite right.
- Taking an impression of the tooth in question- often patched with a little filling or wax to restore the shape of the tooth for making a temporary later.
- Removing any decay and existing filling to get down to natural tooth and then shaping the remaining cavity so the dentist can easily take an impression of it. It is important not to have any undercuts, so the restoration can easily be cemented or bonded- in. The dentist will also remove any weak pieces of tooth to prevent the possibility of fracture in that area in the future.
- Taking a final impression of the cavity on which the lab will make your inlay. This is a crucial step as it is on this model, that they will make the inlay/onlay. The material used is often a silicone, which can take a number of minutes to set (longer than the impression for the opposing model), because it is much more accurate. The dentist will need to check that the impression has recorded every detail accurately and if not, the process will need to be repeated until a suitable impression is recorded.
- The dentist then needs to record how you bring your teeth together by taking a bite registration. Often this is a fast- setting silicone material that is squirted onto your teeth. Then you bite together and keep your mouth closed until it has set. Biting into a piece of wax is another way, and if you have a lot of teeth and a predictable, consistent bite when you close together, that might be all the lab needs.
- Making a temporary. This can be made using the impression taken before the tooth was prepared. It uses a self-cure acrylic, which is inserted into the impression, then reseated inside the mouth and left to harden slightly, before it is removed and polished. This would then be cemented in place with a temporary (weak) cement. There are other types of temporary material available some of which are simply pushed into the tooth, shaped and set (it depends on the dentist’s preferences). The temporary is important, as it stops the tooth from being sensitive and maintains the bite and space between the next tooth- so the final restoration will fit nicely.
- The bite is then checked to ensure that it is not too high; you are then cleaned up and after a rinse- good to go.
There is risk in all surgical procedures and it is important that you are aware of the risks involved in your procedure before going ahead with the surgery. During your appointments you should discuss any concerns with your surgeon and not be afraid to ask questions. Your surgery will be unable to proceed unless you sign a pre-surgery consent form
Note: This information acts as a guide to your possible treatment. Your individual concerns and specific medical history will need to be shared and discussed with your surgeon during your initial consultation.