Dental Inlays & Onlays
Dental inlays and onlays are precision-made restorations fabricated outside the mouth (in a lab or with CAD/CAM milling) and bonded to teeth to repair moderate decay or restore fractured cusps.
They conserve more natural tooth than full crowns and are ideal when a traditional filling would be too weak but a crown would be overly aggressive.
Constructed from porcelain, composite resin, or gold, inlays and onlays provide strength, fit, and aesthetic harmony with surrounding dentition.
Overview And Clinical Background
Conservative Indirect Restorations
Inlays fit within the cusps of a tooth, while onlays extend over one or more cusps and may cover the biting surface.
They are ideal for medium-sized cavities or cusp fractures and restore structural stability while minimizing tooth removal compared with crowns.
- Indication: Moderate decay or fracture that is too extensive for a direct filling but with sufficient remaining tooth structure to avoid a full crown.
- Materials: Porcelain and composite inlays/onlays match tooth color; gold remains an option for exceptional durability in high-stress posterior teeth.
- Advantages: Superior fit, resistance to wear, fewer microleakage issues, and better preservation of natural tooth compared with full crowns.
Symptoms, Signs And Presentation
Patients who benefit from inlays/onlays often report a tooth that is sensitive after large fillings, shows recurrent decay at margins, or has a fractured cusp.
Clinically the tooth may demonstrate compromised integrity but still retain enough structure to support an indirect restoration.
- Common presentation: A tooth with a large filling showing recurrent decay or areas of weakness where a direct restoration would not withstand occlusal forces.
- Functional concerns: Sensitivity to chewing or temperature due to extensive restoration margins or early cusp fractures.
- Red flag: Deep decay reaching the pulp or signs of infection require endodontic therapy before an inlay or onlay can be considered.
Diagnosis Methods And Investigations
Clinical Evaluation And Imaging
Diagnosis includes careful inspection, bite analysis, and radiographs to measure cavity depth and remaining tooth structure.
Digital impressions allow precise lab or in-office CAD/CAM fabrication to ensure an exact fit and comfortable occlusion.
- Radiographs: Bitewing or periapical X-rays assess the extent of decay and confirm adequate tooth structure for an indirect restoration.
- Digital scans: Intraoral scanning captures a precise 3D model for lab fabrication or in-office milling, reducing remakes and improving fit.
- Occlusal assessment: Ensures the restoration will withstand biting forces and integrates smoothly with opposing teeth.
Treatment Options And Surgical Techniques
Treatment generally requires two visits: tooth preparation and impression (or scan), followed by bonding of the fabricated inlay/onlay.
With CAD/CAM, some practices can complete the restoration in a single visit using in-office milling, eliminating temporaries.
- Conservative: Direct composite or smaller fillings remain first-line for minimal damage; inlays/onlays are chosen when size or location favors indirect work.
- Fabrication: Lab-fabricated porcelain or in-office milled ceramic/onlay restorations provide precise occlusion, excellent marginal fit, and durable aesthetics.
- Bonding technique: Adhesive protocols using resin cements create a strong, durable union between restoration and tooth structure, reducing microleakage and improving longevity.
Recovery, Risks And Prognosis
Patients usually experience minimal postoperative sensitivity and resume normal function quickly.
Risks include marginal leakage if bonding fails, fracture under extreme load, or the need for replacement over many years.
With correct case selection and meticulous bonding, inlays and onlays last many years and provide excellent conservative outcomes.
- Typical recovery: Immediate return to normal eating with a short period of mild sensitivity that settles within days as the tooth adapts to the new restoration.
- Potential issues: Fracture if exposed to severe stress, debonding if adhesive technique is compromised, or secondary decay if oral hygiene is poor.
- Longevity: High-quality inlays/onlays commonly last 10–20 years depending on material choice, occlusion, and patient habits.
Why Choose Us
CureU Healthcare provides conservative restorative care using precise digital workflows and high-quality materials to deliver inlays and onlays that preserve tooth structure and restore function.
Our restorative specialists emphasize adhesive technique, occlusal harmony, and long-term monitoring to maximize restoration life and patient comfort.
- Precision workflow: Intraoral scanning and digital design ensure minimal adjustments and exact marginal fit for superior longevity.
- Material expertise: Selection between porcelain, composite, or gold is individualized to balance aesthetics and durability for each tooth.
- Follow-up care: Routine maintenance and occlusal checks prolong restoration life and detect wear or marginal changes early.
Conclusion
Dental inlays and onlays are conservative, durable solutions for moderate tooth damage that preserve healthy structure while restoring strength and aesthetics.
At CureU Healthcare, these restorations are crafted with precision and bonded for lasting function and confident smiles.
