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Ceramic Onlays and Inlays: Recommendations?

posted in Cosmetic Dentistry, Hot Cosmetic Dentistry

« Standard Implants vs. Mini Implants for Lower Overdenture? | Posterior Composites: Any New Developments? »

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Dr. R. asks:
I am about five years from retirement. If I could have afforded to retire now I would. I love dentistry but I am an old fashioned practitioner and I was perfectly happy doing amalgams and porcelain fused to metal crowns. I rarely did onlays because I think they are difficult to do. When I do them, I use gold. Now my patients want posterior teeth restored with composite. They also are asking me about ceramic inlays and onlays. I have never done one. I need to learn this so I can be competitive. Can you please recommend courses I can take and materials I should use. What do you use to cement these in? What kind of guarantee do you give for these kinds of restorations? How much do you charge relative to a gold onlay or inlay? My neighbor uses Empress for high demand aesthetics and Lava for high strength needs.

5 Responses to “ Ceramic Onlays and Inlays: Recommendations? ”

• Doctorberg November 11th, 2008

  
  

  If you are 5 years away from retirement you need to think about what you want. High end posterior aesthetics…. mmmm a simple way is trying to get Ronald Jackson(houston) to teach you, he uses Isosit(concept) and does great work and very predictable too. Dont know if he still teaches though. Resin and resinomer onlays and inlays work very well if they are well indicated and strictly prepared and bonded.
  Posterior ceramics are other thing when you are doing onlays and inlays(much harder)I usually use Everest system for those.
  In terms of posterior full ceramic crowns I go with E-Max press or Procera or Kavo´s everest all with a 5 year warranty and also the same type of preparation also all can be lutted not bonded into place. Nobel has lectures on procera that you can attend.
  But again if you are 5 years away do you really want to get into this?

• Mike Stanley, asst. November 11th, 2008

  
  

  Glad to see you’re still learning new stuff; My dad is over 70 and still adding stuff.
  RE: Fees, you might ask around to see what your local docs are charging. Ask your friends or labs.
  We bond most all of our porcelain, it is best done 4-handed or with rubber-dam for control. We use Calibra and also Variolink with good results.

• rick knecht cdt November 13th, 2008

  
  

  Doc,
  All ceramic restorations are not that hard to do as long as you keep a few things in mind. The floor of the restoration needs to be flat and smooth. The axial walls need to be void of undercuts. Lastly keep in mind path of draw and what you are attempting to do and try to keep the ceramic about 1.5 to 2 mm thick.
  As with any ceramic you will need to bond this in as well or use something like rely x unicem. Here is a website to look at for idea’s on prepping. http://www.jensenindustries.com/authentic/pdfs/Auth_Preps.pdf
  another would be Ivoclars as well.
  Good luck and let us know how things go.
  Rick

• Jason November 18th, 2008

  
  

  Dr. R,
  I use the EMAX press (upgrade of the Empress system)to create ceramic inlays. This system has worked well for my doctors. I have used Lava as well if I am doing an inlay bridge, but it is not needed if it is just a single restoration.

• Dr MB November 24th, 2008

  
  

  Dr R

  If I were you, I would join Pankey and Dawson and learn how to actually HELP the patient by using inlays and onlays. If you get the bite wrong on those inlays and onlays, they will break and you would have been better off doing it in gold as before (?). These guys will teach you how to charge for your time with the patient too. You are there to help them get better, not to give them one unit of dentistry!

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