Porcelain or Tooth Colored Onlays
An onlay restoration is a custom made filling made of composite material, gold, or tooth-colored porcelain. Porcelain onlays are popular because they resemble your natural tooth. An onlay is sometimes also referred to as a partial crown. Porcelain onlays are made by a professional dental laboratory and is permanently cemented onto the tooth by your dentist.
Onlays can be utilized to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays. Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.
As with most dental restorations, onlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.
Often, with only the slightest symptoms, it is possible and even probable to overlook what is actually happening. The 10-20 year old silver filling gradually causes microfractures in the tooth's enamel. Fluctuation of temperature from hot to cold has different effects on different materials, ie. silver fillings and enamel. These changes promote tooth fractures. Here, we replaced the silver filling with a bonded onlay. This white restoration will support the tooth because it is bonded. It will provide a long lasting comfortable restoration.
Before and After
The transitions of the bonded onlay to the natural tooth structure are flawless. This white restoration is in lieu of a white filling or a porcelain crown. The white filling is not as strong and has more shrinkage due to its physical properties and the crown is too aggressive in removing healthy tooth structure. Thus, the bonded onlay is perfect. What a beautiful result!
This patient presented to our New York city office with pain on biting and sensitivity to hot and cold. This is a classic presentation of a fractured tooth. Often, the fractures are not clearly visible and may not show up at all on x-ray. We must diagnose this entirely by symptoms present.
Before and After
Here the fracture is evident. Once the whole pre-existing amalgam filling is removed, the remaining tooth structure is reinforced by overlaying the top. This acts like a shoe to confine the tooth and make it harder to fracture in the future. The beauty of this type of restoration, is that it is a conservative white bonded restoration. It restores the tooth back to almost its original strength.
This patient presented with sensitivity to biting and sensitivity to hot and cold. These symptoms usually are diagnostic of an internal fracture withing the tooth. Since silver amalgams expand at different rates than tooth structure, the constant fatigue on a daily basis can create cracks within the tooth, around the old silver filling. Here we replace the silver filling with a 'white filling' or restoration known as a bonded onlay. Onlays can be made of reinforced resin or porcelain. Both last for many years and protect the natural tooth. Many consider this to be cosmetic dentistry. However, it is also functional dentistry. It is conservative and long lasting.
Before and After
What a beautiful restoration. It duplicates the tooth structure. It is done while conserving natural tooth and protects the tooth by reinforcing the weak points. All silver fillings wear out. When there are signs of wear or fracture, it is best to replace before the tooth breaks in half and requires either root canal treatment or extraction. It also gives the patient the choice to conserve the natural tooth structure without making a crown.
Replacing silver fillings for no reason is, in my opinion, inexcusable. There certainly is a time and place to replace them. Symptoms of thermal sensitivity along with pain on biting could signify an internal fracture. If this tooth is supported with a bonded onlay, the tooth can be saved from serious damage, resulting in root canal treatment, crowns or worse, extractions. Here are just a couple examples.
Before and After
Tooth colored restorations which restore the original strength to the treated tooth.
Before and After
Internal fractures restored in this case, with bonded onlays which eliminated the patent's sensitivity to biting and drinking cold items.
Above photos are actual patients of Joel F. Levy DDS who have given consent for the use of their photos for this website.
Reasons for onlay restorations:
- Broken or fractured teeth
- Cosmetic enhancement
- Decayed teeth
- Fractured fillings
- Large fillings
What does getting an onlay involve?
An onlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (molds) that will be used to create your custom onlay and a temporary restoration.
While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an onlay restoration. A temporary filling will be applied to protect the tooth while your onlay is made by a dental laboratory.
At your second appointment, your new onlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.
You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new onlay.
Porcelain Bonded onlays in New York and Larchmont can be effectively used to restore teeth, eliminating the dark shine through of old failing amalgams(silver fillings) They also restore the tooth to nearly full unrestored strength. Frequently, the walls of the tooth are pushed apart by the silver filling, which acts as a wedge. The tooth colored onlays in New York and larchmont ,as well as anywhere else, will protect the tooth from fracture and leave a pleasant aesthetic result. Conservative tooth colored onlays restore and protect the tooth for many years, while enduring the tremendous forces that they are exposed to. Ice chewing, nut cracking and bone crunching not withstanding. These hobbies should be avoided to prevent damage to the natural teeth as well as tooth colored onlays.