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8/8/2019 Dental Inlay
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DENTAL INLAY
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DENTAL INLAY
Inlay is a an indirect restoration which is
fabricated in the lab and than cemented to
the prepared cavity.
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DIRECT VS INDIRECT RESTORATION
In direct filling the material is taken in plastic
state into the prepared cavity where it
hardens.
In indirect restoration the hardened filling is
cemented into the prepared cavity
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DIFFERENCE
AMALGAM
RESTORATION
INLAY PREPARATION
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Advantages of inlay
Better physical properties
Clinical longevity
Easier to carve a large restoration to normalocclusion and ideal contacts
Easy to make guide planes for removable
prosthesis Easy to alter the occlusion
Aesthetic restoration
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Disadvantages of inlay
Costlier than direct restoration(Gold inlays
cost 4-5 times that of a silver amalgam)
Two visits for the patient Microleakage, dependent on cement
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Types
Gold inlay
Porcelain inlay
Composite inlay
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GOLD INLAY
ADVANTAGES
a) Co efficient of thermal expansion and wear
resistance similar to natural tooth
b) gold is relatively stable and inert in our bodies.
c) Gold does not corrode & is highly polishable
d) Strong even in thin section, can be burnished for
close adaptation
e) Clinical longevity
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GOLD INLAY
DISADVANTAGES
a) Costly(not in long run)
b) Not aesthetic
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Gold inlay
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Gold inlay
indications
a) Failed amalgam restoration
b) Large restorationc) Diastema closure
d) Rehabilitation cases
e) With removable prosthesis
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Gold inlay
Contra indications
a) High caries
b) Young patientc) Esthetic concern of patient
d) Small restorations
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PORCELAIN INLAY
Aesthetically excellent
More cutting for strength and translucency
Can damage opposing teeth if not properlyglazed
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COMPOSITE INLAY
Lab composite is more polymerized and has
more filler content
More strength No polymerization shrinkage
Aesthetically excellent.
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CONTRAINDICATIONS
Cracked teeth (onlay)
Wide isthmus/deep pulpal (onlay)
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Techniques
Two techniques
Direct technique(difficult and tiring for both
the patient and the operator) Indirect technique (easier for both and gives
better result)
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DIRECT TECHNIQUE
Where inlay wax is inserted into the prepared
cavity, carved, contacts made and taken out of
the cavity.
the lab procedure than follow
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Direct technique
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INDIRECT TECHNIQUE
Where an impression of the prepared cavity is
taken and all other procedures are followed
on the model in the lab.
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Indirect technique
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Steps
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steps
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steps
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steps
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steps
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steps
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steps
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CEMENT LUTE
Cement lute is the weakest part of inlay
restoration
Zinc phosphate cement and glass ionomercements have been used for luting
Presently non dissolving resin based luting
agents are used but again the shrinkage
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Controversies
Inlays crack teeth ( careful selection)
Inlays are expensive ( are they?)
Inlays are not esthetic (careful cutting plustooth colored inlays)
Must place bevel at occlusal and proximal
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PREPARATION
Outline form
Resistance form
Retention form Remove any undercuts
Finish the walls
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Outline form
A straight cut tapering fissure bur is used
Caries is removed from all around
Any existing restoration should be removed Occlusally divergent walls (upto10 degrees)
Sharp internal angles
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Outline form
Occlusal dovetail
Butt joint at occlusal
The proximal flare must take the margin intothe respective embrasures clearing the
adjacent teeth
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Resistance form
Minimum depth is 2mm all around
Proximal box should be at least 1-1.5mm
deeper Flat pulpal floor
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Resistance form
If cusps are weak go for onlay preparation
Onlay-an inlay that covers the cusp of thetooth
Cuspal reduction-parallel to the slope
Reduction should not be less than 0.5mmdepending on the material, occlusion, working
or non working cusp All the cusps should be out of occlusion in all
excursions
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Retention form
Retention is based on nearly parallel walls
Up to 10 degree occlusal divergence is allowed
for ease of impression taking and placementof the final restoration
There should be no undercut in the final
preparation
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Finish the walls
A 60 degree gingival bevel is given by using a
gingival margin trimmer
It allows proper seal of the restoration in thisarea
Paint the final outline to provide a more
pleasing outline of the final restoration
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I THANK YOU ALL
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All of the following are advantages of gold
inlay except
a) The co efficient of thermal expansion and
wear resistance is similar to natural tooth
b) Its relatively stable and inert in our bodies.
c) Gold does not corrode
d) A single visit procedure for the patient.