INLAY VS ONLAY

DR. SARA AFIFI

Inlays
What is inlays ?

● An inlay is defined as a restoration which has been constructed

out of the mouth from gold , porcelain or other metal and then
cemented into the prepared cavity of the tooth .

● Inlays incorporate the pits and fissures of the tooth, mainly

encompassing the chewing surface between the cusps.
History of inlays

● Dr. Phil brook in ohw yrtstined ni yalnI ecudortni ot tsrfi eht saw , 1897
, nrettap xaw a dnuora tnemtsevni na gnimrof fo tpecnoc eht evag
. yolla dlog a htiw dlom tnatluser eht gnillfi dna , xaw eht gntianimile
● In 1907 Taggart changed the practice of restorative dentistry by
introducing his technique for cast gold dental restorations
Materials of construction

● Gold
● Cast metal
● Ceramics
● Composite
Indications

● Large class I &class II cavities without involvment of cusps

● Vital posterior teeth
● excessive isthmus width
● Intact buccal & lingual walls
● Inability to maintain dry field
Contraindications

● Patient with bruxism & parafunctional habits

● Bad oral hygine
● High carires index
● Unfavorable occlusion
Advantages

● Excellent mechanical properties

● Good marginal adaptability
● Avoid polymerization shrinkage
● Better control of contour and contacts
● Conservation of tooth structure because no undercuts
Disadvantage

● Two visits
● High cost
● Difficult repair
procedure
● cavity design
● Cavity of at least 2mm depth & 2mm isthmus width
● Parallel walls or with slight convergence (10-12degree)
● Rounded line angles
● Any undercuts are eliminated
● Cavo-surface angle is 90 degree
● An accurate impression is made
● Impression is poured and the restoration is made indirectly in dental lab or
milled by CAD\CAM machine
● Rubber dam installation and try in is done
● Enamel is etched for 30 secs then rinsed and dried
● Cementation of inlay is done by dual cure resin cement or light curing
composite nano hybrid resin with 3 steps adhesive system.
● Excess cement is removed
● Each surface is cured for 40 secs
● Then occlusion is adjusted
● Finishing and polishing
Onlay
What is Onlay ?

● The onlay is essentially an inlay that covers one

or more cusp and adjoining occlusal surface of
the tooth .
Materials of construction

● Gold
● Cast metal
● Ceramics
● Composite
Indications
● Cuspal protection .
● Change of occlusal relation between maxillary and mandibular teeth is
needed .
● Abutment teeth in partial dentures .
● Excessive tooth wear including cusp tip .
● Large cavities / teeth with previous large restoration .
● When a cusp of your tooth is damaged so an inlay or filling can’t be used.
● If you have a cavity on a tooth with a weak structure that may crack if
restored with a regular filling.
● To avoid the removal of the amount of natural tooth structure usually
required to place a crown.
Contraindications

● Patient with bruxism & parafunctional habits

● Bad oral hygine
● High carires index
● Unfavorable occlusion
● Unable to tolerate impression making
Advantages

● Conservative restoration.
● Added strength and durability.
● Natural esthetic look .
● Reduce possibility of future and further decay.
● Easy care and maintenance.
● Biocompatibility.
Disadvantage

● Two appointments needed

● Expensive .
● They are more time-consuming to prepare and insert.
● There are many more margins exposed, allowing more potential
contact with bacterial plaque, so are best placed in patients with
superior oral hygiene
Procedure

● Similar to that of inlay, in addition to cuspal reduction:

❖ Functional cusp reduction

-1.5mm
- Multi - planar
❖ Non - functional cusp reduction
-1.0 mm
-Multi - planar
❖ Functional cusp shoulder
- Uniform 1.0 mm
❖ Functional cusp 2 ° plane
Functional cusp bevel
- Uniform 1.0 mm
❖ Non - functional cusp reduction
-1.0 mm
-Multi - planar
❖ Proximal flares
❖ Gingival bevels

-Bevels continuous