Crown Vs. Onlay (p.26)
Goodbye To Crowns!

By Dr. Edmond Suh

If you aren't quite sure what an onlay is, you're not alone. This innovative procedure for repairing damaged teeth is relatively new, and is the perfect solution for those times when a full crown is too much, and a standard filling may not be enough.

In today's rapidly changing field of dentistry, the main goal your doctor strives to attain is the preservation of your natural teeth. Your dentist is first and foremost looking to maintain the integrity of your teeth and keep them as whole and complete as possible. When there is only a small amount of damage due to cavities, a standard filling is usually recommended. However, for many years, the immediate solution to broken, cracked teeth, or teeth with significant amounts of damage due to cavities, was a crown.

A crown is a porcelain or metal cover that is secured to your natural tooth, encasing its surface. While a crown usually produced a vast improvement to the patient's oral health and appearance, the tooth underneath lost a good part of its mass and was significantly compromised in order to achieve the desired result.

These drawbacks encouraged modern dentists to seek out advanced technologies that would offer a healthier and more aesthetically pleasing option to their patients. Onlays (also called partial crowns) have become popular because they allow your dentist to preserve more of your natural tooth, and can last up to 30 years. When your dentist uses an onlay to repair a damaged tooth, less drilling is required than with a standard filling, which results in less trauma to the tooth and less time in the dentist's chair for the patient. The use of onlays also means that the likelihood of a root canal being required later is greatly diminished.

Onlays are constructed of porcelain, resin compounds, or metal, and are designed to the exact specifications of your tooth by a professional at a dental laboratory. An onlay will cover the rounded, extended areas of the tooth, called the cusps, while its companion restoration, an inlay, will only be placed over the recessed portion of the tooth. To keep matters simple, in this article I'll only use the term onlay to refer to these types of restorations, although in some cases, the use of an inlay may be more appropriate.

Because of their superior fit, onlays are easy to care for and allow for full functionality of the reconstructed area. In fact, your tooth can be easier to clean when you choose an onlay than it would be with a full coverage restorative alternative such as a crown.

What to Expect When You Choose an Onlay

When a client chooses the onlay option, an impression of the compromised tooth is taken, and the impression is delivered to a dental lab, where a skilled technician creates the onlay according to the tooth's exact dimensions. In most cases, a temporary onlay is placed over the tooth to protect it from further damage while the personal, customized onlay is manufactured off-site. When the laboratory completes the onlay, the client will return to the dentist's office, the temporary onlay is removed, and the permanent restoration is placed on the tooth and secured with dental resins.

However, a growing number of dentists are investing in the same-day technology made available by CAD/CAM dentistry, and can complete the entire process in their office, in only a few hours. CAD/CAM technology allows a dentist who is trained in the use of this specialized equipment to produce a precise, high-quality onlay on-site. Because the impression of the damaged tooth does not leave the office and head to a laboratory used by hundreds of other dentists, days of waiting for transit and long production lines are eliminated. A qualified dentist can prepare the tooth, take the impression, create the restoration, and complete the placement – all on the same day! For busy patients with hectic schedules, or for clients who experience anxiety while visiting the dentist, the advantages of this compressed timeframe are significant.

Advantages of Onlays

In addition to their extended lifespan and ease of care, there are several other important reasons to consider repairing a damaged tooth with an onlay.

Your dentist is committed to your comfort, always striving to find the restorations that require the least amount of drilling and will reduce the time that you will need to spend in their office. An onlay is the least invasive and most efficient way to repair a damaged tooth.

Onlays can be made from tooth-colored material, including porcelain and composite resin, making them practically invisible. These white restorations are often used in the areas that are exposed when you smile. Only you and your dentist will know you've had work done. Also, tooth-colored onlays will not stain – they keep your white smile bright!

Unlike traditional metal fillings, an onlay will not expand or contract in response to temperature changes caused by hot or cold foods and beverages. This change in size of a traditional filling can cause teeth to weaken or fracture. An onlay protects your tooth from dramatic temperature changes and resulting damage.

Because of the way onlays are created, they help to strengthen teeth by up to 75%. By saving teeth with cavities, the use of an onlay prevents the need for more extensive treatment further down the road.

Your dentist will help you decide which reconstruction method is best for your damaged tooth. Not every dentist is familiar with the process of preparing your tooth for an onlay and fitting it correctly, so be sure to ask your dentist about their experience with this innovative procedure.

For more information regarding the benefits of repairing your teeth with onlays, contact your dental care provider – he or she can help you decide if they are the perfect choice for your healthy smile.

Supremia Dentistry with Dr. Edmond Suh is located at 1711 S. Main Street in Wake Forest. He may be reached at 919-556-6200 or visit www.advancementsindentistry.com.