Dental Inlay

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.

Dental Inlay

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