inlay, onlay

[marimo]

nowadays still got ppl do onlay and inlay? or just directly put crown?

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[Mackchops]

I've had good luck with e.max. Chairside with a Cerac or pressed from the lab.

 

[RaeRae0903]

I work for a dentist who does inlays/onlays multiple times a day. They save healthy tooth structure but still provide a strong, long lasting restoration. His practice thrives off of cerec. Then again, he is one of very few that I know to have ever utilized this technology so I can't say that they are necessarily a "common" procedure per se...

 

[Contach]

They save healthy tooth structure but still provide a strong, long lasting restoration. His practice thrives off of cerec.

How long have you been working with him?
How long has he had cerec for?

 

[RaeRae0903]

I've worked with him for over 6 years. He's been doing them since ~1999 from what I recall. I know it's been over 10 years, just not certain on the exact year.

 

[Contach]

My experience with inlays/onlays hasn't been good. I've seen several inlays/onlays fail (delivered from my predecessors) and had to re-do them.

What does he use to cement them?
Please, I am curious to know how he does it so well..

 

[RaeRae0903]

Honestly, I think he's used a few different cements over the years...I will be sure to ask him next week when we all come back from vacation (Thursday). As far as I've seen in the practice, from time to time things come "unglued" or crack but comparing to the the number he does it can only be a very insignificant number. It's typically the cerec crowns that I've noticed have come off when they do and that is still a rarity. His onlays hold up very well (I'm a hygienist so I don't help him with placement but have seen them year after year (oth clinically and on xray) after placement and when people actually take care of their mouths they look as good 10 years later as they did on day one. They look as though they've been "poured" into the tooth. But getting back to the cement, I will find out for you ASAP. I recall him mention using a newer 3M product recently though...if that helps at least in the mean time. 😉

 

[RaeRae0903]

Oh and another thing...not to knock your predecessors as I do not know them, but it seems that many dentists don't learn the product well enough and aren't as trained as they should be with cerec which could be a reason for the failed restorations. My boss is a trainer for cerec so he's pretty darn good at it. 😉

 

[Contach]

How many times have you heard the phrase "composites are the best restorative material if done right". It seems like I've heard that from every dentist I've ever met.. makes you wonder who is doing it wrong...?

 

[RaeRae0903]

Hmm...I guess it does. But composite is essentially plastic, right? From what I've learned it was always that amalgams hold up longer than composite but that composites are still preferred over amalgam for esthetics and lack if mercury. Cerec on the other hand is a pressed porcelain so it's stronger than the other two (and supposedly stronger than the original tooth structure), making it the longest lasting restoration. To be fair, I'm taking most of this from "hear say" (and my boss) rather than having researched this myself...so it could be biased information. Lol

 

[Rlow04]

Hmm...I guess it does. But composite is essentially plastic, right? From what I've learned it was always that amalgams hold up longer than composite but that composites are still preferred over amalgam for esthetics and lack if mercury. Cerec on the other hand is a pressed porcelain so it's stronger than the other two (and supposedly stronger than the original tooth structure), making it the longest lasting restoration. To be fair, I'm taking most of this from "hear say" (and my boss) rather than having researched this myself...so it could be biased information. Lol

You're absolutely right. Composite is a polymer. Right now the average lifespan of a class 2 restoration out in practice is 6 years. Amalgams are lasting around 12 but no one wants them. Some of the new materials like e.Max that can be milled in CEREC are looking extremely promising in strength and durability.

Dr. Gordon Christensen and his wife just lectured at my school and they showed scanning electron microscope images of composites vs e.Max after a year in the mouth. The composites were failing all over the place, while the e.Max looked brand spanking new.

 

[RaeRae0903]

Yup. My boss does eMax on certain patients (i.e. those that are heavy clenchers/grinders). And he is a devout follower of Christensen's methodologies. I'm always hearing "As Gordon Christensen says..." 😉

 

[RaeRae0903]

Oops. Sorry. Double post.

 

[RaeRae0903]

My experience with inlays/onlays hasn't been good. I've seen several inlays/onlays fail (delivered from my predecessors) and had to re-do them.

What does he use to cement them?
Please, I am curious to know how he does it so well..

Ok so I checked on that for you and he uses Ivoclar vivadent's Multilink Automix. Hope that helps! Let me know if there's any other info I can get you. 🙂