Inlays, Onlays And Veneers

Question 1

When is an inlay useful?

Answer 1

Occlusal cavities

Occlusal / interproximal cavities

Replace failed direct restorations

Question 2

What are the indications for an inlay?

Answer 2

Premolars or molars

Occlusal, MO or DO restorations

MOD if kept narrow

Low caries risk pt

Question 3

Advantages of inlay vs direct restorations?

Disadvatages?

Answer 3

Superior materials and margins
And
Won’t deteriorate over time

But

Increased time
Cost

Question 4

What things are needed in a prep for an inlay?

Answer 4

Tapered walls and no undercuts!!!!!

Correct Isthmus

Adequate depth

Correct margin

Margins clear of occlusal contact points

Clear contact points

Rounded internal line angles

Question 5

Dimensions of ceramic inlay prep?

Answer 5

Isthmus: 1.5-2mm

Depth: 1.5mm

Margin: min 1mm shoulder or chamfer

Question 6

Dimensions of gold inlay?

Answer 6

Isthmus: 1mm

Depth: 1.5mm

Margin: 0.5mm chamfer

+- occlusal key and dovetail, retention aspects

Question 7

Indications for onlay?

Answer 7

Sufficient occlusal tooth substance loss

Caries

A cusp remaining

MOD wide isthmus

Pre existing large restoration

Question 8

When use onlay?

Answer 8

Tooth wear cases
- increase OVD

Fractured cusps

Restoration of root treated tooth

Replace failed direct restoration

Question 9

Reductions needed for porcelain onlay?

Answer 9

1.5mm non functional cusp

2mm functional cusp

1mm shoulder or chamfer

Question 10

Reductions needed for gold inlay?

Answer 10

0.5mm non functional

1mm functional

0.5mm chamfer

Question 11

1st appt for inlays / onlays?

Answer 11

LA if tooth not RCT

Make reduction template

Imp for temp

Tooth prep

Make temp

Take imps, bite reg and shade

Cement temp

Question 12

Inlays / onlays second appt?

Answer 12

Remove temp

Isolate, clean and dry tooth

Try fit, occlusion and adaptation of crown

Cement or address problems

Minor occlusal adjustments if needed

Question 13

What is a laminate veneer?

Answer 13

Thin layer of cast ceramic that is bonded to labial or palatal surface of tooth, with resin

Question 14

Indications for veneer?

Answer 14

Improve aesthetics
- tooth discolouration

Change teeth shape or contour
- enamel defects

Correct peg laterals

Reduce or close proximal spaces and diastema’s

Align labial surfaces of in standing teeth

Question 15

Contraindications for veneers?

Answer 15

Poor OH

High caries rate
- interproximal caries

Gingival recession
- poor aesthetics

High lip lines

> 50% surface area no longer enamel

Heavy occlusion

Poor bonding surface

Severe discolouration

Question 16

What prep is needed for a veneer?

Answer 16

0.3mm cervical reduction with slight chamfer supra or slightly sub gingival

0.5mm midfacial reduction within enamel

1-1.5mm incisal reduction with bevel

Question 17

How temporise veneer?

Answer 17

Fit pro temp restoration

No need if direct veneer

Spot bond composite
- single spot bond with no etch into centre of tooth
- composite veneer on top

Question 18

Alternatives to veneers?

Answer 18

No tx

Micro-abrasion

Penetrative resin - ICON bleaching

Direct composite

Crown?