When we talk about restoring badly worn down or chipped teeth, the first thing that comes to mind is dental fillings. Most of us are aware of the tooth coloured composite dental fillings which, are perhaps being most commonly used by dentists throughout the world for restoring damaged teeth. However, did you also know that there is another type of dental fillings available which are even stronger, naturally appearing and more durable than the conventional tooth grinding composite dental fillings? Yes, these types of fillings are called indirect fillings and are referred to as inlays and onlays.
What are direct and indirect dental fillings?
Before we discuss why inlays and onlays are better than conventional tooth fillings, let us first understand the difference between the direct and indirect fillings.Direct Fillings
Dental Amalgam: These tooth fillings are based on the mixture of powdered metal alloys with liquid mercury. These direct fillings have been used for restoring teeth for more than 100 years. However, their use has declined these days as research has indicated the possible toxic effect of mercury on the human body.
White Fillings: These tooth coloured fillings consist of a mixture of resins and glass fillers. The best thing about these fillings is that they can exactly match the shade or colour of your teeth. Composite resin fillings are suitable for restoring small tooth defects, owing to their excellent aesthetics and sufficient durability.
White Temporary Fillings: Some types of white fillings which are of a Glass Ionomer material, are meant for temporary use only and will not last long, which has contributed to some of the misconception that white tooth colored fillings are not as lasting as metal fillings.
Indirect restorations include ceramic or resin inlays, onlays, gold fillings, partial crowns, bridges, and veneers. Amongst them, inlays and onlays can also be used to restore the same types of cavities as direct fillings, and the advantage is that they are stronger and last much longer than direct fillings.
What are inlays and onlays?
Inlays are indirect restorations that are used for the restoration of grossly damaged or fractured teeth, to provide a stronger repair option that can last longer compared to regular fillings. They are used when the damage is not extensive enough to require a crown. Inlays are used in cases where the damage has not progressed into the cusps, which are the protuberances surrounding teeth that are present on the biting surfaces of teeth. In cases where there are one or more cusps are involved, then an onlay or crown will need to be used instead for more protection to the tooth.
Although numerous types of materials can be used for preparing ceramic indirect filling, we use high-quality materials that have been approved by European and American standards. Instead of using temporary filling or leaving it to an external laboratory, we prepare inlays directly in our clinic's in-house laboratory by using the state of the art CEREC system. As such, we ensure that you will not only get a naturally beautiful and attractive smile from tooth filling, but they will also be functional hence restoring your ability to chew and speak properly.
How are ceramic fillings prepared with the CEREC System?
Here’s how we will provide a beautiful smile with ceramic and hybrid ceramic inlays with the CEREC system:
- Consultation: In the first step, our dentists will perform a detailed examination of your teeth and current dental health status. We will prepare a comprehensive treatment plan for you which will be customized according to your dental and aesthetics needs.
- Tooth Preparation: In the next step, we will remove the cavities and damaged tooth surface. If the damaged tooth structure is too deep and there is a chance of accidental exposure of the underlying pulp, we will administer local anesthetic to make you completely pain-free.
- Impression Making: After tooth preparation, we will make a digital impression of your teeth with special intraoral scanners of the CEREC system. This impression will then be fed into a software which will allow us to design of an inlay which exactly fits the prepared tooth.
- Fabrication of the Ceramic Inlays: Finally, we will use 3-D computer-aided manufacturing (CAM) milling machine which will carve out the inlay from a ceramic or zirconia block. The lab technician will then hand-finish it to ensure the inlay is the same shape and colour as your natural teeth. Your dentist will then insert the prepared inlay into the prepared tooth cavity, just like a filling, and bond it to the tooth with an adhesive cement.
Why do we use the CEREC system for preparing ceramic inlays?
You might now be wondering why we prefer digital inlays over conventional ones. So, here are a few reasons why CEREC inlays are better than direct fillings:
- Exceptional Precision and Fit : The CEREC inlays are prepared by using state-of-the-art CAD/CAM. Therefore, unlike direct fillings and conventional inlays that are prepared in the laboratory, the CEREC inlays are prepared under highly controlled precision2. As a result, they will perfectly fit the prepared teeth thus diminishing chances of development of secondary decay.
- Durability: The CEREC inlays are prepared from very high-quality ceramics. Therefore, they are quite strong and durable, even more than the tooth coloured composite fillings and conventional inlays. With proper care, you can expect these ceramic fillings to last for more than ten years3.
- Lifelike Aesthetics: With CEREC system, we can tailor-make each aspect of your inlays including their shape, thickness and colour. Therefore, when we restore your damaged tooth with a ceramic filling made with the CEREC system, it will be virtually indistinguishable from your teeth.
- Tooth Conservation: Conventional inlays and amalgam restoration often require sacrificing healthy tooth structure. However, thanks to the CEREC system, we only need to remove the tooth structure which is damaged. Therefore, there is enough tooth structure remaining to prevent tooth fracture4.
- No Need for Making Physical Tooth Impressions: Many patients dislike the taste or feeling of the impression material which is used to record the shape and size of the teeth. This problem has been solved with the CEREC system. After preparing the damaged tooth, we use digital scanning for making an impression, which is like taking a video of the tooth with a camera inside the scanner. This digital impression is not only more accurate and precise, but it also reduces the inconvenience of the patients.
- Enjoy a Same-Day Smile: Conventional ceramic inlays need at least two sittings for their preparation and tooth restoration. This may take weeks before you can get your teeth restored. However, this is not the case with the CEREC system. Thanks to the CEREC machine, we only need a few hours to prepare your inlays. This means that you can enjoy the smile of your dreams in just a single sitting!
While ceramic tooth fillings are an excellent choice for restoring damaged teeth, they can never be as strong and durable as your teeth. Therefore, the best tooth filling is undoubtedly no tooth filling at all! However, if you still need to get one of your teeth replaced, then ceramic inlays prepared with the CEREC system should be your first choice remaining tooth.
So, are you ready for enjoying a naturally pleasant dental filling and beautiful smile? Then book an appointment with our dentists today and let us take care of the rest.
- Martin N, Jedynakiewicz NM. Clinical performance of CEREC ceramic inlays: a systematic review. Dent Mater. 1999 Jan;15(1):54-61. doi: 10.1016/s0109-5641(99)00014-7.
- Hopp CD, Land MF. Considerations for ceramic inlays in posterior teeth: a review. Clin Cosmet Investig Dent. 2013 Apr 18;5:21-32. doi: 10.2147/CCIDE.S42016. PMID: 23750101; PMCID: PMC3666490.
- Heymann HO, Bayne SC, Sturdevant JR, Wilder AD Jr, Roberson TM. The clinical performance of CAD-CAM-generated ceramic inlays: a four-year study. J Am Dent Assoc. 1996 Aug;127(8):1171-81. doi: 10.14219/jada.archive.1996.0408. PMID: 8803392.
- Bremer BD, Geurtsen W. Molar fracture resistance after adhesive restoration with ceramic inlays or resin-based composites. Am J Dent. 2001 Aug;14(4):216-20. PMID: 11699740.