This is an article for our French clients on dental inlays and onlays written by Dr. Bruno Delaunay.

Définition :

Derrière ces deux mots très techniques se cachent en réalité des solutions thérapeutiques modernes pour restaurer vos dents victimes de lésions carieuses. 

L’inlay et l’onlay sont de plus en plus proposés, leur essor va de pair avec le développement d’une dentisterie dite « à minima ». 

Un inlay et un onlay sont deux prothèses très similaires. 

On utilisera le terme : INLAY, pour des petites lésions. Alors qu’on utilisera le terme ONLAY quand la lésion s’étend à au moins une cuspide.
 

Pourquoi l’inlay et l’onlay sont des solutions modernes ? 

L’inlay et l’onlay respectent les principes de la dentisterie à minima. Dans le passé, en cas de lésion de taille moyenne, les dentistes ne pouvaient proposer que les deux solutions suivantes :
 

• Un composite qui n’est mécaniquement pas fait pour être utilisé sur des grandes cavités mais qui est toujours la solution idéale sur les caries de petite taille.
• La couronne qui permet de recréer une dent à l’identique. Elle est parfaitement indiquée en cas de dent très délabrée car elle permet de rétablir l’esthétique et la fonction de la dent.

Cependant, elle nécessite la « préparation » de toute la dent, et requiert d’endommager de supprimer la structure dentaire saine restante (si il en reste). Désormais un inlay ou un onlay, permettent de reconstituer la dent, de manière, pérenne, solide, étanche et esthétique sans avoir à éliminer la structure saine de la dent.

Le déroulement de la séance:

Après avoir retiré la partie cariée, le dentiste réalise une empreinte qui sera transmise au laboratoire. Ce dernier qui peut donc travailler « hors de la bouche » pourra créer une pièce prothétique parfaitement sur mesure et ajustée à votre dent.Pendant la deuxième séance, le dentiste colle l’inlay céramique en suivant un protocole rigoureux pour garantir la longévité de la restauration.

Avantages :

L’inlay et l’onlay permettent la pratique d’une dentisterie conservatrice ou « à minima » et sauvegardant le plus possible l’organe dentaire.Parce qu’il est le plus souvent en céramique, il possède une durée de vie bien supérieure au composite.Il est parfaitement adapté à la dent et limite la réapparition de la carie.Il procure un rendu esthétique proche d’une dent naturelle.

Inconvénients :

Sa réalisation nécessite 2 séances séparées de plusieurs jours pour permettre au technicien dentaire de réaliser l’inlay.Comme tout travail prothétique, il nécessite des rendez-vous de contrôle pour prévenir les récidives carieuses ou fractures.

Pour plus d’informations n’hésitez pas à consulter le Dr Bruno DELAUNAY du cabinet Progressive dentistry.

My next article will focus on the alternative to white fillings, which are porcelain onlays and inlays. These are, on the whole, laboratory made restorations for the teeth. These are often required when extra strength is required to protect the underlying tooth that cannot be afforded by direct white fillings. There are many advantages to porcelain inlays and onlays.

1. They are biocompatible and therefore there is no issue with any toxic component. 

2. They have similar wear strengths to tooth enamel. 

3. They do not shrink. 

4. They do not take up moisture over time leading to material distortion. 

5. Porcelain does not change colour or stain. 

6. Porcelain can be used to restore heavily broken teeth, even those with only a third of the remaining underlying tooth available. 

7. Porcelain can be adhesively bonded to the underlying tooth, creating a super seal from bacteria. 

8. Porcelain inlays and onlays require less tooth preparation than conventional crowns. 

9. As they are made in the laboratory, the technician will be able to create all manner of contours and adaptations that would not be possible with a direct filling. 

10. Porcelain inlays and onlays look just like teeth! 

If you would like totally biocompatible porcelain restorations for your teeth, please do not hesitate to contact us on 0207 7311162 or e mail info@progressivedentistry.co.uk

One of the most common questions we answer is whether metal fillings should be replaced. I have complied a list of 10 points about metal fillings and why I think they have had their day and alternative treatments should be sought:

1. Metal fillings contain up to 50% mercury.

2. Mercury is a toxin.

3. Mercury is continuously released from metal fillings via a vapour form.

4. Metal fillings do NOT stick to teeth, they are mechanically wedged in to place.

5. Metal fillings require the tooth to be cut deeper than white fillings as they rely upon an undercut in the tooth i.e wider base than top surface.

6. Metal fillings corrode over time leaving areas open to bacterial leakage.

7. Metal fillings cannot be repaired.

8. Metal fillings leach ions within the tooth to give a grey appearance.

9. Metal fillings cannot be placed next to gold crowns as this may lead to a galvanic effect and increase the corrosion rate.

10. Metal fillings look awful.

Modern replacements include composite resin fillings and porcelain inlay and onlay restorations. My next article will list points why these materials are superior than metal fillings.

Article written by Dr Nissit Patel

If you would like to know more about removing metal fillings, then please do not hesitate to contact us on 020 7731 1162 or e mail info@progressivedentistry.co.uk

A recent study by the European Commission has recommended phasing out the use of dental amalgam owing to mercury's negative impact on the environment. The study also stated that some dentists are ''reluctant to change their current practice and invest in new equipment to handle mercury free fillings''. 

At Progressive Dentistry, we do NOT use any mercury containing metal fillings. Dr Nissit Patel says '' I would not want a metal filling placed in my mouth or in my children so I will certainly not consider placing them for my patients. With modern dentistry and the development of adhesive dentistry, white tooth coloured restorations can be placed predictably and safely with fantastic aesthetic results.'' The options vary from direct composite fillings, to indirect porcelain fillings and crowns. We constantly invest in the latest technology and materials, to offer our patients the very best in dentistry today. 

If you would like to change your metal fillings, please contact us today. You may be surprised at what we can offer.

The question is often asked 'what is the best filling for my tooth?' The answer lies in the material which is most like a natural tooth. The options range from amalgam (metal fillings), white fillings, gold fillings or porcelain inlays/onlays. The benefits of porcelain inlays/onlays are:

1. It is 100% bio compatible.
2. It will not shrink in the mouth.
3. It is not affected by water/saliva/heat or cold.
4. It has a wear strength similar to tooth with adequate thickness and properly polished/glazed.
5. It looks just like natural teeth.
6. It does not require heavy destructive preparation of the underlying tooth (in most cases).

Below is case completed by Dr Nissit Patel, where 2 molar teeth were heavily decaying under amalgam metal fillings.
 

Dental crowns are often an excellent way of restoring badly broken down teeth. However, for teeth that have failing fillings or have part fractured then adhesive dentistry is often the answer. With minimally invasive techniques and the latest technologies, we are able to restore teeth with inlays and onlays. These are made from gold or ceramic (porcelain) and only replaces the damaged part of the tooth. Crowns are destructive and involve stripping the tooth of precious enamel. Inlays and onlays adhesively bonded to teeth are far less destructive and provide a long lasting alternative to crowns. Porcelain is also a highly aesthetic and indistinguishable from natural tooth, an added bonus!