Decay is removed and the tooth is prepared prior to an impression being made. This detailed mold is sent to a dental laboratory that will create a porcelain (tooth colored) restoration called an inlay or onlay. The inlay or onlay is then bonded into the prepared surface of the tooth.
An inlay replaces only internal surfaces of the tooth whereas an onlay is larger and covers one or more cusp tips.
Porcelain inlays and onlays enable the tooth to be restored in a durable and esthetic way. Since they are made in a dental laboratory, these restorations have stronger physical properties than composites and can be more meticulously sculpted. They are bonded to the tooth, helping to prevent tooth fracture and actually strengthening the tooth. They are made to perfectly match the shade of the tooth and therefore are virtually undetectable. Inlays and onlays require the removal of only decayed or weak areas of the tooth, leaving more healthy tooth structure intact. This can increase durability and help prevent the expense of root canal therapy in the future.
Due to the fact that they are crafted in a laboratory, porcelain inlays and onlays require a greater initial investment than composite fillings. However, in the long run these restorations are a better investment than fillings due to their greater durability. Gold restorations are even more durable than porcelain.
In cases of extensive decay or loss of tooth structure, crowns are the only alternative. For smaller areas of decay, composite fillings are an excellent choice.
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