Information – Porcelain Fillings

Porcelain Fillings, also known as Inlays and Onlays, restore a tooth to its natural size, shape and colour. They improve the strength, function and appearance of a broken down tooth that may otherwise be lost.

Inlays and onlays are dental restorations that cover back teeth. The difference between an inlay and an onlay is that an inlay covers a fairly small part of the biting surface of a back tooth while an onlay extends over the biting surface and on to other parts of the tooth. Both of these restorations are cemented into place and cannot be taken off.

The likely outcome of this procedure is the restoration of a near-healthy tooth in appearance, form and structure, which will require future maintenance including replacement of the restoration as it ages.

The Procedure

The filling procedure following diagnosis and acceptance to proceed involves: local anaesthetic numbing, drilling and cleaning, a scan or impression, a temporary restoration.  At the second visit, local anaesthetic numbing, removal of the temporary restoration, particle abrasion, etching, bonding, placing the resin filling, light curing the filling and finally adjustment of the shape, bite and polishing for smoothness.

Following the procedure, the limitations of the porcelain filling may be that is has a good color match with adjacent natural teeth when first placed, but less of a match as your natural teeth age.  A porcelain filling may chip or break if used for abnormal activities (e.g., biting fishing line, sewing thread or finger nails, opening bottles) and it may de-bond in heavier bite scenarios.

After the procedure, Check-ups are important to ensure the tooth health is monitored and that continued treatment is provided if necessary.

The Cost

We will give you an outline of the estimated cost of your Porcelain Filling.  At the time of your First Stage of the Filling Appointment we may need to alter the design and size of the porcelain fillings, and until such time the estimate of the cost is an estimate only.  Following your filling there may be other relevant costs dependent on the outcome such as future replacement, cost of further treatment including review, a root canal treatment or extraction of the tooth.  These additional costs are all incurred by the patient.

Alternative Treatments

• Alternatives to placing an inlay/onlay are to either place a crown or a direct restoration such as tooth coloured or silver fillings.
• Crowns are less conservative in their preparation and therefore weaken remaining tooth structure more than inlays/onlays.
• Composite and amalgam restorations remove decay and may restore teeth to their original form but are limited because they:
– Do not improve the strength of broken down teeth.
– Do not improve the long term function and aesthetics of broken down teeth as well as inlays/onlays.

Abnormal Outcomes and Risks

In having an inlay/onlay, some inherent risks exist both to the tooth and to the restoration itself.

The risks to the tooth are:
• Preparation for an inlay/onlay weakens tooth structure and permanently alters the tooth underneath the restoration.
• Preparing for and placing an inlay/onlay can irritate the tooth and cause “postoperative” sensitivity which may last for up to 3 months.
• The tooth underneath the inlay/onlay may need root canal treatment about 5% of the time during the lifetime of the tooth.
• If the cement seal at the edge of the inlay/onlay is lost, decay may form at the juncture of the restoration and tooth.

The risks to the inlay/onlay are:
• Porcelain may chip and metal may wear over time.
• The inlay/onlay may debond and may therefore require rebonding or replacemment with a crown at additional expenses
• If the tooth needs a root canal treatment after the inlay/onlay is permanently cemented, the procedure may fracture the restoration and the inlay/onlay may need to be replaced.

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