What are Direct and Indirect Fillings?

However, before we discuss why inlays and Onlays are better than conventional filings, we must first understand the difference between the direct and indirect fillings.
- Direct Fillings –. These tooth coloured fillings are placed directly inside the tooth after removal of the demineralized and damaged tooth structure. The most common types of dental fillings are the silver amalgam fillings and white fillings
- Dental Amalgam – these 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 and colour of your teeth. Composite fillings are suitable for restoring small tooth defects, owing to their excellent aesthetics and sufficient durability.
- Indirect/ Ceramic Fillings – as their name suggests, these ceramic fillings are not directly placed inside the tooth. Instead, your dentist will remove the damaged tooth structure and, in most cases, take a dental mould of the tooth, which is then sent to the dental laboratory. At the dental laboratory, this impression will be used to prepare the ceramic restoration. This process is time-consuming, requiring a longer time and at least 2 appointments. If the dentist has an intraoral scanner and chairside milling system, this process is much simplified. At Dental Designs Clinic, the dentist will make a digital impression of your teeth by using an intra-oral scanner, and the ceramic filling can be designed and made on the spot for immediate use in the mouth.
Indirect restorations include inlays, onlays, crowns, bridges, and veneers. Among them, inlays and onlays can also be used as fillings, and the advantage is that they are stronger and last longer than direct fillings.
What are Inlays?
Inlays are indirect restorations that are used for the restoration of grossly damaged or fractured teeth that cannot be restored with direct filling materials, but at the same time, they are 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 that are present on the biting surfaces of teeth.
Although numerous types of materials can be used for preparing ceramic inlays, at Dental Designs Clinic, we use high-quality materials that have been approved by European and American standards. Instead of leaving it to an external laboratory, we prepare inlays in our clinic 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, but they will also be functional, restoring your ability to chew and speak properly.
How are Ceramic Fillings Prepared with the CEREC System?

Here’s how we will give a beautiful smile with ceramic and hybrid ceramic inlays with the CEREC system:
- Consultation – 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 your 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 anaesthesia to make you completely pain-free.
- Impression Making – after tooth preparation, we will make a digital impression of your teeth with the special intraoral scanners of the CEREC system. This impression will then be fed into a special software which will help us in designing of an inlay which exactly fits the prepared tooth. The computer-aided design (CAD) software will also allow us to create the inlays which have the same shape and colour as your natural teeth.
- 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. We will then insert the prepared inlay into the prepared tooth cavity just like a filling and bonded to the tooth with an adhesive cement.
Why 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 and conventional inlays.
- Exceptional Precision and Fit – the CEREC inlays are prepared by using a state-of-the-art CAD-CAM Therefore, unlike the direct fillings and conventional inlays prepared in the laboratory, the CEREC inlays are prepared under highly precise and controlled precision. As a result, they will perfectly fit the prepared teeth, and they will prevent chances of development of secondary cavities.
- 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 years.
- Lifelike Aesthetics – with CEREC system, we can tailor-make each aspect of your inlays including their shape, thickness, colour, and 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 fillings 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 fracture.
- No Need for Making Physical Tooth Impressions – many patients dislike the taste or feeling of the impression material which is used to recording 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 and that too, in under 2 hours.
While ceramic fillings are an excellent choice for restoring damaged teeth, but they can never be as strong and durable as your teeth. Therefore, the best filling is undoubtedly no 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.
So, are you ready for enjoying a naturally pleasant and beautiful smile? Then book an appointment with our dentists today and let us take care of the rest.
References
- Clinical Performance Of Cerec Ceramic Inlays: a Systematic Review
N. Martin-N.M. Jedynakiewicz - (https://www.sciencedirect.com/science/article/abs/pii/S0109564199000147) - The Clinical Performance Of Ceramic Inlays: A Review
Mark Bergman - (https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1834-7819.1999.tb00217.x) - Three-dimensional finite element analysis of strength and adhesion of composite resin versus ceramic inlays in molars
(https://doi.org/10.1016/S0022-3913(08)60029-3) - Considerations For Ceramic Inlays in Posterior Teeth: a Review
Christa Hopp-Martin Land - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666490/) - The Clinical Performance Of Cad-cam–generated Ceramic Inlays: A Four-year Study
Harald Heymann-Stephen Bayne-John Sturdevant-Aldridge Wilder-Theodore Roberson - (https://www.sciencedirect.com/science/article/abs/pii/S0002817715609953) - Molar fracture resistance after adhesive restoration with ceramic inlays or resin-based composites
(https://europepmc.org/article/med/11699740)