INLAY, ONLAY & Overlay

What is a Dental Inlay?

Inlay, Onlay, and Overlay?are cosmetic crown fillings that are used for large cavities when the tooth structure is very damaged. Sometimes the term ‘play’ is also used when the Inlay/Onlay/Overlay is held in place by a pin or pins.

A dental inlay, also known as a tooth inlay, is essentially a filling that sits inside your tooth and is used for restorative work.?It rebuilds the chewing surface of the tooth and unlike a normal filling which is built up inside your tooth by the dentist, an inlay is actually created in a laboratory as a solid piece before being placed inside your tooth by the dentist.?An inlay is only used when the cusps of the tooth are still intact. These should not be confused with a bone inlay (graft) which is something completely different.

What is a Dental Onlay?

A dental Onlay, or tooth Onlay, is also used for dental restorative work.?However, unlike the inlay, it sits?on?the tooth rather than in it.?It rebuilds not only the chewing surface but?also part of the cusps (either one or both). It, too, is constructed in a laboratory as one solid piece and attached to the tooth by the dentist.

What is Dental Overlay?

A dental overlay is more extensive than both an inlay and Onlay. Constructed in a laboratory, an overlay is a partial crown that rebuilds the chewing surface and cusps in addition to part of the lateral surfaces of the tooth.?In comparison, a crown usually covers the?entire?lateral surface of a tooth down to the gum

What Is The Difference Between Inlays and Onlays?

In simple terms, an inlay sits inside the tooth, an Onlay sits on the tooth and covers the biting surface of the tooth and at least one cusp and an overlay sit on the tooth and cover both cusps and part of the lateral surface of the tooth.?An Onlay or overlay may be required where there is more extensive damage to the cusps or edges of the tooth or sometimes the actual biting surface of a tooth.

Inlay/Onlay/Overlay vs Filling

Generally, a dentist will consider filling a tooth when a maximum of 40% of the tooth is damaged. A filling is considered a ‘direct’ filling because it can be applied in one visit directly by your dentist in his surgery.?Inlays and Onlays are considered to be ‘indirect’ fillings because, like crowns, they are made in a laboratory. This means that a patient will need at least two visits to the dentist – one visit for cleaning and to either take a mold of the tooth or digitally scan it, and the second visit to have the Inlay/Onlay/Overlay fitted.?Inlays, Onlays, and overlays are used when a tooth is too badly damaged or decayed to have a simple filling (about 40%-60% of the tooth is damaged) or when a filling would be so big it could weaken the whole structure of the tooth. The goal of a dentist is always to save a tooth where possible, so if they think a dental filling won’t do the job, they may offer an inlay, Onlay, or Overlay.

Inlays Vs Onlays

You’ve probably heard of?getting crowns or fillings?put in place to fill in cavities and dental decay. However, you may not have heard of some of the alternatives, such as?dental?Inlays and Onlays.

Usually, fillings are used to fill in small cavities, while crowns are used when the decay is deeper or if there is a larger fracture to be covered up. However, there may be situations when a filling is not enough, and a crown is too much to protect against dental decay.?Dental inlays and Onlays?are what many dental professionals will then use if they need something “just right” to fill in those gaps. They are more substantial than fillings, but not as intrusive as a crown, which may involve reshaping the teeth in some way.?

But what is the difference between the two?

At their most basic definitions, an?Inlay?fills in cavities and hollows in a tooth in the areas between the cusps. An?Onlay?will not just fill in cavities in those spaces, but they can work for a larger area, including the cusps.?They work similarly to crowns, but they do not cover the entire surface of the tooth. They are both made from the same materials, and they both serve the same function, but they cover different areas of the tooth to properly protect when there is tooth decay.?

What are Inlay and Onlay in Dentistry?

1. Inlays?are molded and fitted into the chewing surface of a tooth that has been damaged through decay or injury. They are created using an imprint of the affected areas that are sent to a lab for manufacturing. An?inlay?will fit perfectly into the hollow of the tooth, but they do not affect the cusps. When the dentist takes the impression, they also attempt to best match the color of the tooth as closely as possible. This way when they are placed in the mouth they are not noticeable. The material used for an?inlay?can be either?porcelain or a composite material?that is stronger and more durable than traditional fillings. This makes?inlays?generally more expensive, but also longer lasting. A dentist chooses this option when a filling will not properly strengthen the surrounding tooth and the cavity requires stronger materials to fortify the tooth.?
2. Onlays?are used for decay and damage to the cusps of a tooth as well as the biting surface. A dentist will choose an Onlay when a cavity is too big to fill with standard?amalgam fillings, or when the tooth could crack due to weakness. An?Onlay?will shore up the strength of the tooth along with protecting the decaying area.?Unlike an inlay, this area can include the cusps as well as the space in between. The dentist prepares the tooth in a similar fashion to a filling, by drilling out the cavity and cleaning up the area after placing a numbing anesthetic in the mouth. A temporary Onlay is then placed over the cavity, and the impression is sent for a permanent Onlay to be manufactured. It is then placed in the mouth when it arrives. With an?Onlay, the tooth structure is preserved, whereas with a crown some filing and even removal of cusps may be necessary. They are also made of porcelain or composite material.?Onlays?are also called “partial crowns” because they serve a similar function but they only cover a portion of the tooth, as opposed to the entire thing.?

How Long Do Inlays and Onlays Last?

• One of the main benefits of inlays and Onlays is how durable and long-lasting they can be. You can expect an inlay to last anywhere between?5 and 30 years.?Dental professionals?cannot guarantee how long they’ll last due to a variety of factors. Some can undergo more wear and tear than others, and if they are not cared for, then they can get damaged or fail sooner than expected.?
• One of the biggest factors is how well the patient approaches their dental hygiene habits after inlays are put in place. This means brushing twice a day, flossing every day, and following any special recommendations from?the dentist. A patient must go to the dentist for follow-up visits to check on the stability and health of the inlays or Onlays to make sure that they are firmly in place.
• Along with proper hygiene, patients should do what they can to reduce wear and tear on the inlays and Onlays. Grinding teeth can cause cracking and damage. If a patient is grinding in their sleep, then the dentist can provide nightguards or other solutions to lessen grinding or protect the teeth. Chewy or hard food can also affect the longevity of inlays and Onlays. Hard food can crack the material, and chewy food that sticks to the material can cause the bonds to loosen.?
• So, while there is no firm number when it comes to?how long they will last, you should expect them to last longer depending on how well you take care of them and your overall oral health.?

Is an Onlay Better Than a Crown?

The main difference between an Onlay and an inlay is that an Onlay will cover a larger area that an inlay cannot cover. An Onlay can cover the cusps of the tooth, but an inlay fills in the spaces in between. This might sound a lot like a crown, and there are some similarities, but they serve different purposes.?

An Onlay is used when the dentist determines that the restoration does not have to be as aggressive as it would be with a?crown. That means that more of the structure of the tooth can be preserved. A?crown?covers the entire tooth, and significant reshaping of the tooth is necessary to have one installed. An Onlay can be more difficult to get right, which is why the skill and experience of the dentist are so important. So neither is necessarily better than the other, and a dentist will recommend what suits the situation the best.?

Are Inlays Better Than Fillings?

Just as with the?Onlay versus crown?debate, there are several facets to determining if?inlays?are better than?fillings. In general, inlays are better in that they can fill a larger cavity, and they are more durable. The amalgam in?fillings?can expand and contract depending on the temperature, for example. This can lead to cracking of the filling, or even the tooth itself. They are as durable as inlays, which can last for decades at a time. Inlays do not have this problem, and in fact, will strengthen the tooth. This is because they are custom-made by using an impression, so they fit perfectly into the cavity. They strengthen the tooth so much that in some cases it can handle up to 75% more chewing force than it could before the decay.

A note from Dr. Mansour Majed?

-GP Dentist?- Master’s of Fixed Prosthodontics

What are Inlays, Onlays, and overlays? How do they differ from direct dental fillings?

Inlays

• When the tooth decay area is too bigger for a general dental filling, an inlay will be considered an alternative method. Inlays usually cover the central part of the tooth or the area between the cusps and are positioned within the hard tissues of the tooth. They do not cover the cusps. For this reason, they are shaped to fit perfectly on your teeth, so can prevent leftovers from entering underneath tooth decay areas, creating further decay.?The material used for inlays usually is porcelain like other dental crowns, so it will be stronger and more durable compares with other composite fillings.

Onlay

• ?When a patient gets decay of the middle and side of their tooth, an Onlay can be considered a treating method as it may cover one or more cusps of your tooth. Compared with inlay, Onlay covers more areas, they are positioned inside the deep tissues of the tooth as well as cover part of the biting surface of the tooth. This helps to protect the damaged tooth from a direct chewing load.

Overlay

• Overlays cover a much larger portion of the occlusal or biting surface. Though they are often compared to partial crowns, overlays are very different from crowns. The main difference is overlays keep more of the natural tooth structure intact

What is the difference between direct fillings, Inlays, Onlays, and Overlays?

Dental Filling

1. Size: large or small, depending on the position of the tooth decay
2. Function: Used to treat tooth decay in the early stages, preventing tooth decay from spreading
3. Production process: The dentist will fill the tooth directly at the dental office, not through the production lab
4. Duration and durability: Fast treatment time, not as durable as inlays, onlays, and overlays, but still the most effective treatment for small, non-serious caries
5. Low price

Inlay

1. Size: small size because it only covers the central point of the treated tooth and does not cover the cusps
2. Function: When the patient has severe caries, the cavity is large and spreads on the tooth surface
3. Production process: The dentist will take an impression of the teeth, then send it to the production lab. The manufacturing process is similar to a denture, including dental design, milling, contouring, and staining.
4. Treatment: Dentists will use dental glue to stick the inlay piece to the treatment area. The patient’s natural teeth are less affected by inlay teeth keeping up to 60-70% of natural teeth.
5. Time and durability: It usually takes 10-15 days for the patient to receive the inlay teeth. Part of the inlay production material is porcelain, so the inlay has high durability.
6. Cost: is the same as one complete tooth

Onlay

1. Size: the size is larger than the inlay tooth because it covers the central point of the treated tooth and covers 1 part of the cusps
2. Function: When the patient has severe caries spreading to the cusp, or the tooth has a slightly chipped tooth that needs covering
3. Treatment: Dentists will use dental glue to stick the piece of Onlay tooth to the treatment area. With Onlay teeth, patients retain 50-60% of their natural teeth.
4. The production process, durability, and cost: similar to inlay teeth

Overlay

1. Size: the size is almost the same as a complete denture, so dentists often consider the overlay and crown to be the same
2. Function: Used to replace severely damaged and chipped cases of natural teeth, and the roots are still in good working order.
3. Treatment: Dentists will use dental glue to stick the piece of onlay tooth to the treatment area. Patients will retain about 20-30% of their natural teeth with overlay teeth.
4. Process, time, durability, and cost: similar to inlay teeth.

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