When a tooth has been moderately to extensively destroyed by decay, previous drilling, or fracture but there is still sufficient enamel remaining, one innovative way it can be restored is with a porcelain inlay or onlay. An inlay is a restoration in which a portion of occlusal (biting) surface is replaced with porcelain. An onlay will restore a larger portion of the biting surface of the tooth. These are considered very conservative restorations. The porcelain allows an excellent esthetic result. It is attached to the tooth using a bonding procedure, allowing it to become very strong. It can be used with wonderful results in small, medium, and even large restorations lasting more than 12 years, relatively trouble-free.

A dental laboratory is involved in the construction of the restoration. There is a 2- to 3-week delay while the inlay or onlay is being made, so the tooth must have a temporary restoration in place during that time.

They have some disadvantages. They are moderately expensive to very expensive to make and place. They take two appointments to complete. They must be adjusted and polished well or they can cause wear of the opposing enamel, similar to a porcelain fused to metal crown. Of course, we make sure they are adjusted and polished well to begin with. Porcelain biting surfaces can cause more rapid wear of opposing natural teeth, especially in the posterior areas where a metal biting surface may be advised.Advantages include the excellent esthetics, high strength, predicted longevity, and conservative preparation, that is, less drilling than a crown. If the porcelain does chip, it can be repaired. However, you should not chew ice cubes, “jaw breakers,” or any other hard candy with these or any other type of restoration.

For those who want the strongest, longest-lasting, conservative restoration that very closely matches a tooth, porcelain is possibly the best choice. Once it is finished, the tooth, if cared for properly, should not have to be restored again for years. It does allow the conservation of most of the natural tooth.

Resin Resin inlays and onlays are used in the same areas as the porcelain inlays and onlays. They are very natural in appearance and, like porcelain, are bonded into place. They are considered an extremely conservative restoration. Two appointments, approximately 2 weeks apart, are required to fabricate the resin inlay/onlay. The tooth will be protected with a temporary filling while the final restoration is being made. The wear of the resin is similar to that of enamel. So unlike porcelain, it will not have a tendency to wear the opposing natural tooth structure. The resin may be considered slightly “weaker” than porcelain. However, porcelain is more brittle and more difficult to repair. The difference in strengths is not significant. The resin is more forgiving and is more easily finished or repaired and resin is easier to work on.With both types of materials, porcelain or resin, you can develop decay on unrestored surfaces, so excellent oral self-care is required. Neither material is advised for patients who have a bruxing (grinding) or clenching habit unless a protective mouthguard is constructed for you.

Unless you have a preference, we will select the most appropriate material for your dental needs. Cost of each is comparable. Both types are excellent choices and are considered highly conservative in the amount of drilling needed.

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