Replacing large fillings in back teeth often requires stronger, more precisely contoured restorations. These are called inlays or onlays depending on whether they are being placed inside the tooth or on its outer surface.
A porcelain onlay restoration is a custom made filling that is made of composite material, gold, or more commonly a tooth-colored porcelain. Porcelain onlays are very popular because they closely resemble the natural tooth. A porcelain onlay is made at a professional dental laboratory, and is then permanently cemented into the tooth by your dentist. The purpose of inlays and onlays is to strengthen teeth or replace old or damaged fillings. One of the chief benefits of porcelain inlays and onlays is that they provide a highly strong, aesthetic, natural look, especially when compared to metal fillings. Another advantage is that they are extremely durable, capable of lasting decades.
Onlays can be used to conservatively repair teeth that have large defective fillings, or have been damaged by decay or trauma. They are the ideal alternative to conventional silver and composite fillings. Also, porcelain onlays are more conservative, compared to crowns, as less tooth structure is removed during the preparation of onlays.
Unlike inlays, porcelain onlays are placed on the cusps of the damaged or broken tooth. Onlays are placed in a manner very similar to inlays, requiring two visits to the dentist’s office.
As with most dental restorations, you should know that porcelain onlays are not always permanent and may require replacement someday. However, they are highly durable and should last many years.
Patient presented with decay and fractured cusps (cusps are needed to support your bite). Due to the loss of cusps a porcelain onlay was done. This conserved as much natural tooth structure as possible and alleviated the need for a radical approach of making a crown. The benefits of porcelain onlays are: retaining as much of the natural tooth as possible, less sensitivity, smooth feel to the tongue, very strong structure that does not fracture (unlike white fillings), color stability and the maintenance of patient’s bite.
Reasons for onlay restorations:
- Broken or fractured teeth
- Cosmetic enhancement
- Decayed teeth
- Fractured fillings
- Large fillings
Advantages of Onlays:
- Better contour to the affected tooth, resulting in a healthier gum.
- Less food impaction.
- Extremely durable, high-strength compared to white fillings.
- Outstanding color match and translucency mimicking the natural tooth.
- Less bacterial leakage due to superior fit.
- Less wear and tear on your bite compared to white fillings, in which there is severe wear and tear due to the forces of the bite.
What does getting an onlay involve?
A porcelain onlay procedure typically requires two appointments. The first appointment includes taking several, highly accurate, impressions (molds) that will be used to create your custom onlay and temporary restoration.
First, the dentist will numb the tooth and remove any decay and/or old filling materials. The space is then thoroughly cleaned and carefully prepared. The surface is shaped to properly fit the onlay restoration. A temporary filling is applied to protect the tooth while your onlay is made by a dental laboratory.
The experience of the master ceramicist in fabricating the natural-looking inlays and onlays is as important as the cosmetic dentist who prepared them. Therefore, the communication between the cosmetic dentist and the master ceramist to create the masterpiece is of vital importance.
At your second appointment, your new onlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and to ensure that your bite is comfortable.
When your treatment is completed, you will receive care instructions. It’s important to keep in mind that good oral hygiene, eating habits, and regular dental visits will aid in the life of your porcelain onlay(s).