An inlay is a form of dental prosthesis manufactured in the dental laboratory that can be permanently inserted into the tooth. In most cases, extensive carious defects are treated with an inlay. It is also possible, however, to treat dental defects resulting from trauma with an inlay.
In contrast to classical, plastic filling materials (plastic), which are inserted into the tooth in liquid form and then hardened, an inlay is shaped to fit exactly and then glued into the tooth to be treated. For this reason, inlays are usually much more resilient and have a longer average durability than ordinary tooth fillings. In dentistry we generally distinguish between: In some cases inlays are also made of gold-ceramic mixtures.
- Gold –
- Ceramic-
- Plastic and
- Titanium Inlays
As the name suggests, a ceramic inlay consists of particularly stable, unbreakable ceramic. In the dental laboratory a ceramic inlay can be produced in different ways, depending mainly on shape and size. In contrast to the somewhat more stable gold inlay, a ceramic inlay has the advantage that it is indistinguishable from the normal tooth substance and therefore inconspicuous.
Furthermore, a ceramic inlay is particularly suitable for patients who have little natural tooth substance left after removal of a carious defect. Due to the close connection between the dentin (lat. dentine) and ceramics, the tooth structure can be strengthened and the tooth can be made more resilient.
In the case of small carious defects, the removal of which still leaves sufficient tooth substance, it is usually sufficient to make a filling with amalgam or plastic materials. In the case of extensive caries and large losses of tooth substance, however, in addition to the actual filling of the hole, care must also be taken to ensure that stability is maintained during the chewing process. In the case of ordinary fillings, there is generally a loss of stability, which means that the affected tooth can only insufficiently withstand the forces acting on it during chewing.
For this reason, after the removal of a large caries, the preparation of a ceramic inlay should be considered. Before the ceramic inlay can be made in the dental laboratory, some preliminary work must be done. On the one hand, the treating dentist must completely remove the carious defect and ensure that all germs are completely eliminated from the cavity (tooth cavity).
This treatment step takes about one hour, depending on the extent of the carious defect. The cavity must then be prepared to receive the ceramic inlay. The ceramic inlay can only find an optimal hold if all the depressions of the affected tooth are cleanly ground off.
After successful preparation of the tooth an impression of the dentition must be taken. The dental technician can only make an accurately fitting ceramic inlay with the help of an impression that is as accurate as possible. After the preparation of the tooth to be restored, the exact tooth color of the patient must be determined.
This step in particular is essential for the production of a ceramic inlay that will later sit inconspicuously in the oral cavity. Since the inlay takes a few days to produce in the dental laboratory, the prepared tooth must first be provisionally restored. For this purpose, the dentist makes a temporary filling made of plastic in the dental office.
After the ceramic inlay has been made in the dental laboratory, it can be glued into the tooth in a second treatment session. In order to protect the tooth from saliva and bacterial pathogens, it is completely sealed with the help of a rubber band (so-called “cofferdam”). This is followed by the removal of the temporary filling material and the preparation of the tooth cavity.
In order to ensure an optimal hold and improve the bond between the tooth surface and the ceramic inlay, the cavity must be roughened by applying a chemical acid. In order to prevent the tooth from being hypersensitive to heat, it is then sealed with a special material. The actual insertion of the ceramic inlay usually takes only a few minutes.
After applying the adhesive material, the inlay is inserted into the cavity and its fit is checked by ultrasound. Then the adhesive must be activated and cured by the application of UV light. An optimally adapted ceramic inlay cannot be distinguished from the natural tooth surface after insertion.A ceramic inlay is fully resilient relatively quickly after insertion.
However, the patient should observe a few basic things in the first few hours after the inlay has been bonded: 1. eat: Immediately after the visit to the dentist, the patient should not eat for about three to four hours, as the adhesive used must dry completely during this period. This is the only way to ensure an exact fit and an optimal marginal seal. If too much pressure is exerted on the ceramic inlay during this period, this can have a negative effect on the interaction between the inlay and natural tooth substance.
In this case, premature loss or displacement of the ceramic inlay within the cavity can occur. In addition, there is a risk that food residues may settle in the not yet fully cured adhesive and subsequently serve as a breeding ground for bacterial pathogens. The consequence can then be the formation of new carious defects under the ceramic inlay.
2. oral hygiene: After the treatment with a ceramic inlay, special attention must be paid to thorough and regular oral hygiene. In addition to the usual tooth cleaning with a toothbrush, the interdental spaces should also be cleaned at least once a day. Dental floss or interdental brushes (interdental space brushes) are particularly suitable for this purpose.
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