Onlays rock!

[kerrydds06]

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I just did my first onlay (MODBL #18) and I'm in love. The prep was more detailed than for a full gold crown but there was no need for a crown lengthing(which was needed if crowned), the prep was more conservative, achieved full cuspal coverage and the margins were smoother than silk. Patient was very satisfied.
What do you guys think of this type of restoration?
What do you doctors in practice think, do you do many onlays?

 

[anamod]

I just did my first onlay (MODBL #18) and I'm in love. The prep was more detailed than for a full gold crown but there was no need for a crown lengthing(which was needed if crowned), the prep was more conservative, achieved full cuspal coverage and the margins were smoother than silk. Patient was very satisfied.
What do you guys think of this type of restoration?
What do you doctors in practice think, do you do many onlays?

I think they have there time and place. As one of the lab techs at our school said they are much harder to obtain an accurate restoration (a lot more margins). I personally don't think I will do to many of these, but I could change my mind.

 

[JesseBrad3]

What sort of situation would an onlay work better in than a crown? Is an only really just a gold crown (excuse my ignorance)?

 

[Gutta Percha]

I do porcelain onlays on many pts. I've done a few gold onlays but haven't had much need for them. Onlays are great when replacing a large MOD restoration with an undermined cusp in a nonbruxer and pt. with limited parafunctional habits. You conserve more tooth, they are very easy preps and look fabulous.

 

[JesseBrad3]

Thanks Gutta Percha, that helps. Are the porcelain onlays 100% porcelain or are they fused with gold/metal, or can it be either one?

 

[kerrydds06]

As one of the lab techs at our school said they are much harder to obtain an accurate restoration (a lot more margins). .

I am one of two lab technicians in my class and I do my own lab work whenever I can because it is faster than sending it out. I do my own castings because I know best where my margins are and I think that the onlay is easier because the margins are crystal clear. 😉

 

[emsi]

gold inlays rock... the best restorative material/technique for posterior cavities. made in perfect way, they last forever. porcelans are also good, but their marginal adaptivity is less satifactory compred with those of gold ones.

 

[omsres]

gold inlays rock... the best restorative material/technique for posterior cavities. made in perfect way, they last forever. porcelans are also good, but their marginal adaptivity is less satifactory compred with those of gold ones.

I agree with the above two posts. You cant go wrong with a conservative preparation. Don't let lab techs dictate when accurate margins can be obtained. If they can't find a margin or adapt the margin either they suck or your prep/impression sucked. I made 10 onlays in during my third and fourth years and if you do it right the margins should be perfect. Most of the time margins will be supragingival. I believe gold is a superior material for these because the margins can be burnished down to glassy smoothness. I don't have any experience with all porcelain inlays/onlays though.

 

[TX OMFS]

I agree with the above two posts. You cant go wrong with a conservative preparation. Don't let lab techs dictate when accurate margins can be obtained. If they can't find a margin or adapt the margin either they suck or your prep/impression sucked. I made 10 onlays in during my third and fourth years and if you do it right the margins should be perfect. Most of the time margins will be supragingival. I believe gold is a superior material for these because the margins can be burnished down to glassy smoothness. I don't have any experience with all porcelain inlays/onlays though.

I examined all ten of omres's onlays last year, right after I pulled the teeth they were in.

 

[north2southOMFS]

Dude, would you two just shut up. As oral and maxillofacial surgery residents I believe you are no longer qualified to speak of matters pertaining to the restorative dentistry field. Especially you TX OMFS, you were only a hygenist.

 

[TX OMFS]

Dude, would you two just shut up. As oral and maxillofacial surgery residents I believe you are no longer qualified to speak of matters pertaining to the restorative dentistry field. Especially you TX OMFS, you were only a hygenist.

Are general dentists allowed to talk about pulling teeth? n2s, I assume that because you have interjected yourself in the banter you are prepared to take the heat. Just don't take it personal b/c I still love you and your fiancee. Say, do you play the trombone? BTW, you left your magazine at work:

 

[kerrydds06]

Can SDN users keep the critism constructive please. If you have beef with someone's views, send them a PM. It looks bad on us all as professionals especially when this site is open to the generel public. (in other words, don't let the kids see mommy and daddy fighting)
Thank you all for your understanding.

 

[Midoc]

kerry - check those three's previous posts. I believe they are joking.

 

[TX OMFS]

kerry - check those three's previous posts. I believe they are joking.

Yes we are. We all are in residency together. Besides, omsres's mother and I argue in public all the time, usually about paternity and child support issues.

Look here's a picture of them with his stepdad:

 

[Dino_D]

I just did my first onlay (MODBL #18) and I'm in love. The prep was more detailed than for a full gold crown but there was no need for a crown lengthing(which was needed if crowned), the prep was more conservative, achieved full cuspal coverage and the margins were smoother than silk. Patient was very satisfied.
What do you guys think of this type of restoration?
What do you doctors in practice think, do you do many onlays?

There seems to be a movement towards porcelain/ceramic inlays and onlays these days. During school I only did full cast gold ones and had great results with every one. However, not many people these days will go for the gold option for obvious reasons. IMO I think they need a little more attention to detail than crowns and are also tougher to temporize and cement compared to crowns.

Having said that there are definitely indications for inlays/onlays but given the choice I would usually go with a crown since I find them more predictable. If you are doing a full cuspal coverage onlay on that molar then you are really not that far away from a crown prep either.