Indirect Restorative Dental Materials (Two or more visits)

Sometimes the best dental treatment for a tooth is to use a restoration that is made in a laboratory from a mold.  These custom-made restorations, which require two or more visits, can be crowns, inlays or onlays.  A crown covers the entire chewing surface and sides of the tooth.  An inlay is smaller and fits within the contours of the tooth.  An onlay is similar to an inlay, but it is larger and covers some or all chewing surfaces of the tooth.  These restorations are made in a dental laboratory by highly trained technicians.  Advances have developed where computer assisted systems allow porcelain restorations to be made in the dental office in about an hour.  Materials used to fabricate indirect restorations are porcelain (ceramic), porcelain fused to metal, gold alloys, base metal alloys and composite resins.

All-Porcelain (Ceramic) Dental Materials

All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns.  They are used as inlays, onlays, crowns and aesthetic veneers.  A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth.  All-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel.  They are absolutely beautiful!  If done properly they are indistinguishable from a natural tooth.  Although they are beautiful, the restorations are more prone to fracture when placed under tension or on impact.  Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth structure.  There are newer “tooth colored” materials that go underneath the porcelain that allow for greater strength.

Porcelain-fused-to-Metal

Another type of restoration is porcelain fuse to a substructure of metal.  These restorations are very strong and durable.  The combination of porcelain and metal creates a stronger restoration than porcelain used alone.  More of the existing tooth must be removed to accommodate the restoration.  While porcelain-fused-to-metal restorations are highly biocompatible, some patients may show an allergic sensitivity to some types of metals used in the restoration.

Gold Alloys

If you want a restoration to last for years and years – go with gold.  Gold alloys are a blend of gold and a variety of other metals that result in a strong, effective filling, crown or a bridge.  They are primarily used for inlays, onlays, crowns and fixed bridges.  Gold alloys exhibit high strength and toughness that resists fracture and wear.  This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration.  High content gold alloys are also gentle to opposing teeth and are well tolerated by patients.  However, their metal colors do not mimic natural teeth so they are typically utilized in areas where esthetics is not a concern. 

Base metal alloys

Base metal alloys are non-noble metals with a silver appearance.  They are used in crowns and fixed bridges.  Although they are very strong, I don’t utilize these because some patients may show allergic sensitivity to the base metals.

Indirect Composites

Crowns, inlays and onlays can also be made in the laboratory from dental composites.  These materials are similar to those used in direct fillings and are tooth colored.  One advantage to indirect composites is that they do not excessively wear opposing teeth.  Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration, but they can blend with natural tooth structure very well.

 Incredible advances in materials are being made daily and your choices will continue to expand over time.