If over half of your molar tooth's biting surface is decayed or missing, an inlay or onlay may be a better option than a filling. Inlays and onlays are used when more than a filling is needed but less than a crown will do. An inlay is placed in between the cusps of the tooth, whereas an onlay will cover one or more of the cusps. They are created to replace the correct anatomy of the tooth. Inlays and onlays are created using porcelain, and the color of the porcelain can be created to match the natural tooth color as well as the bonding cements that are used so that they blend seamlessly with the tooth structure. An inlay or onlay is a more conservative treatment than a crown and allows us to preserve some natural healthy tooth structure. The result is a beautiful, natural-looking restoration.
Inlays and onlays are performed using very similar procedures. Both require two appointments.. During the first appointment, we begin the procedure by numbing the area using a local anesthetic. The decayed or damaged structure is removed using a drill, preparing the tooth for its new surface. After all the damage is removed, an impression is made of the prepared tooth so the inlay or onlay material can be cast in a form that will fit the tooth exactly. A temporary restoration is placed on the tooth to protect it until the laboratory makes the inlay or onlay and it can be bonded to the tooth. This can take about three weeks.
Using the impression, a laboratory prepares the new tooth surface using gold, porcelain, or composite resin. When you return for your second appointment, the temporary restoration is removed and the surface is cleaned to prepare for the new structure. We will then “try in” the new restoration to ensure that it fits correctly without interfering with your bite. If the fit is good, the inlay or onlay is permanently attached to the tooth using special cement or bonding. Some minor adjustments may need to be made to the restoration if there are interferences. To finish the procedure, we will polish the cemented or bonded structure and tooth.