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References

Vale WA. Cavity preparation. Irish Dent Rev. 1956; 2:33-41
Aquilino SA, Caplan DJ. Relationship between crown placement and the survival of endodontically treated teeth. J Prosthet Dent. 2002; 87:256-263
Moraschini V, Cheung KF, Monte Alto R, Oliveira dos Santos G. Amalgam and resin composite longevity of posterior restorations: a systematic review and meta-analysis. J Dent. 2015; 43:1043-1050
da Veiga AMA, Cunha AC, Ferreira DMTP, da Silva Fidalgo TK, Chianca TK, Reis KR, Maia LC. Longevity of direct and indirect resin composite restorations in permanent posterior teeth: a systematic review and meta-analysis. J Dent. 2016; 54:1-12
Rasines Alcaraz MG, Veitz-Keenan A, Sahrmarln P, Schmidlin PR, Davis D, lheozor-Ejiofor Z. Direct composite resin fillings versus amalgam filling for permanent or adult posterior teeth. Cochrane Database Syst Rev. 2014; 31:(3) https://doi.org/10.1002/14651858.CD005620.pub2
Opdam NJM, Bronkhorst EM, Loomans BAC, Huysmans MC. 12-year survival of composite vs. amalgam restorations. J Dent Res. 2010; 89:1063-1067
Mannocci F, BerteIli E, Sherriff M, Watson TF, Ford TR. Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration. J Prosthet Dent. 2002; 88:297-301
Mannocci F, Qualtrough AJ, Worthington HV, Watson TF, Pitt Ford TR. Randomized clinical comparison of endodontically treated teeth restored with amalgam or with fiber posts and resin composite: five-year results. Oper Dent. 2005; 30:9-15
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All-Ceramic inlays and onlays for posterior teeth

From Volume 46, Issue 7, July 2019 | Pages 610-624

Authors

Richard Ibbetson

BDS, MSc, FDS RCS(Eng), FDS RCS(Ed), FFGP(UK) FFD RCSI, FRCA

Director, Edinburgh Postgraduate Dental Institute, The University of Edinburgh

Articles by Richard Ibbetson

Ian R Jones

BDS, MSc MBA, FInstLM, MFDS RCPS(Glasg)

Clinical Senior Lecturer, Institute of Dentistry, University of Aberdeen, Scotland

Articles by Ian R Jones

Abstract

The increasing requirement for aesthetic restorations has been matched by the continuing improvements in dental materials and fabrication techniques. These factors have resulted in the development of newer ways of making tooth-coloured restorations for posterior teeth. The value of preserving tooth tissue is widely appreciated and the use of partial coverage restorations can assist this aim. The use of porcelain inlays and onlays etched with hydrofluoric acid together with improved composite resin-luting agents offers the dentist and patient the option of a conservative and aesthetic restoration for more extensively damaged posterior teeth. The paper describes the indications and clinical procedures for the use of these restorations.

CPD/Clinical Relevance: Porcelain inlays and onlays offer a predictable alternative to full coverage crowns and should be part of the clinician's armamentarium.

Article

There is no clearly defined point at which it is better to provide an indirect rather than a direct restoration. There is a number of factors which influence the decision:

The impact of the loss of tooth tissue on the strength of that which remains can be significant. Vale in 1956 was one of the first investigators to describe the weakening of the tooth resultant from Class II cavity preparations.1 This has been verified by numerous researchers over the years, but it cannot easily be related to clinical outcomes. The point at which the risk of fracture becomes likely has never been clearly defined, although it is evident that root-treated posterior teeth are particularly at risk unless the final coronal restoration does something to protect the remaining tooth tissue.2 The continued development in adhesive materials and the decline in dental caries have encouraged a more conservative approach to cavity preparation which has both pulpal and structural benefits. The ability to produce adhesion between a restorative material and tooth structure is potentially a key element in developing or retaining strength in what remains of the tooth. However, this has not been quantified clinically, but there can be little argument that the principle is correct.

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