Porcelain Inlays and Onlays

Porcelain

When a tooth has been moderately to extensively destroyed by decay, previous drilling, or fracture but there is still sufficient enamel remaining, one innovative way it can be restored is with a porcelain inlay or onlay. An inlay is a restoration in which a portion of occlusal (biting) surface is replaced with porcelain. An onlay will restore a larger portion of the biting surface of the tooth. These are considered very conservative restorations. The porcelain allows an excellent esthetic result. It is attached to the tooth using a bonding procedure, allowing it to become very strong. It can be used with wonderful results in small, medium, and even with large restorations lasting more than 12 years, relatively trouble free.

A dental laboratory is involved in the construction of the restoration. There is a 2- to 3-week delay while the inlay or onlay is being made, so the tooth must have a temporary restoration in place during that time.

They have some disadvantages. They are moderately to very expensive to make and place. They take two appointments to complete. They must be adjusted and polished well or they can cause wear of the opposing enamel, similar to a porcelain fused to metal crown. Of course, we make sure they are adjusted and polished to begin with. Porcelain biting surfaces cause more rapid wear of opposing natural teeth, especially in the posterior areas where a metal biting surface may be advised.

Advantages include the excellent esthetics, high strength, predicted longevity, and conservative preparation, 

that is, less drilling than a crown. If the porcelain does chip, it can be repaired. However, you should not chew ice cubes, “jaw breakers”, or any other hard candy with these or any other type of restoration.

For those who want the strongest, longest-lasting, conservative restoration that very closely matches a tooth, porcelain is possibly the best choice. Once it is finished, the tooth, if cared for properly, should not have to be restored again for years. It does allow the conservation of most of the natural tooth.

Resin

Resin inlays and onlays are used in the same areas as the porcelain inlays and onlays. They are very natural in appearance and, like porcelain, are bonded into place. They are considered an extremely conservative restoration. Two appointments, approximately 2 weeks apart, are required to fabricate the inlay/onlay. The tooth will be protected with a temporary filling while the final restoration is being made. The wear of the resin is similar to that of enamel. So unlike porcelain, it will not have a tendency to wear the opposing natural tooth structure.

The resin may be considered slightly “weaker” than the porcelain. However, porcelain is more brittle and more difficult to repair. The difference in strengths is not significant. The resin is more forgiving and is more easily finished or repaired and resin is easier to work on.

With both types of materials, porcelain or resin, you can develop decay on unrestored surfaces, so excellent oral self-care is required. Neither material is advised for patients who have a bruxing (grinding) or clenching habit unless a protective mouthguard is constructed for you.

Unless you have a preference, we will select the most appropriate material for your dental needs. Cost of each is comparable. Both types are excellent choices and are considered highly conservative in the amount of drilling needed.

If you have any questions about porcelain or resin inlays and onlays, please feel free to ask us at any of our office locations:

Hymeadow: (512) 250-5012

Jollyville: (512) 346-8424

West William Cannon: (512) 445-5721

Prevention of Decay

Dental Decay

Dental caries (decay) is a bacterial infection, first of the enamel, then of the dentin of the tooth. The tradition in dentistry has been to surgically remove the diseased portion of the tooth by “drilling” out the decay and then filling the resulting hole in the tooth with some inert material. As most adults know, this procedure will be performed over and over again when new decay begins or when the filling (often silver) breaks or the tooth fractures.

Would it not be better to eliminate the cause of the infection and thus not be forced to have big holes drilled in the teeth? We believe the bacterial cause of the infection should be addressed.

Preventing the Risk of Dental Decay

There are several positive steps that you can take to reduce your risk of dental decay. First, all of the active decay in your mouth should be treated immediately. Next, all the teeth that would benefit from sealants should be treated. This will prevent bacteria from reaching into the pits, fissures, and grooves that normally exist on the occlusal (biting) surface of teeth. Any stray bacteria that may still be in the sealed area are effectively cut off from their food source and become inactive. Although sealants are most effective on teeth that have not been previously restored, they can be successfully placed on teeth filled with bonded fillings.

The infection can be treated with antimicrobials. We believe that the use of a fluoridated mouthrise twice daily or use of a prescription fluoridated dentifrice as directed provides great advantage. Not only is fluoride effective against bacteria but it also creates an environment that promotes remineralization of slightly damaged enamel. The decay process is reversed and the tooth may not have to be drilled. We may also prescribe a chlorhexidine mouthrinse, an antimicrobial oral rinse that has a great effect on Streptococcus mutans.

Your diet and oral self-care are important in dental decay prevention. When you eat junk food and drink sugary liquids, your teeth are more prone to decay. The more frequently you snack, the more prone your teeth will be to decay. If your brushing and flossing are not effective, your teeth will be more prone to decay. When you can’t brush after a meal, at least rinse your mouth with water within 15 minutes to dilute the acids forming from the ingested food or drink. If you have a diminished salivary flow, take frequent sips of water during the day to help dilute the acids produced by the bacteria.

If you have a continuing problem with active decay, we recommend more frequent preventative recare appointments. It has been repeatedly shown that patients who have good oral self-care and maintain a recare interval of 3 to 4 months have many fewer dentally related (cavities or gum disease) problems.

The routine 6-month recare interval is no longer our recommended schedule. That interval was based on a 50-year-old philosophy that never had any scientific basis! Times have changed. Present dental practice is based on proven scientific information. You might need to have your teeth cleaned by the hygienist twice each year or you may need to be seen more frequently.

For certain individuals, we also suggest testing the oral bacterial levels to determine the magnitude and presence of a Streptococcus mutans infection and to determine your risk level for future dental disease.

How to Overcome Your Smile Insecurities

Everyone deserves to have a smile that expresses self-confidence and inner beauty. Unfortunately, too many people are insecure about their smile when the sources of their unhappiness can easily be fixed. Turns out, with some simple, cost-effective, and painless cosmetic dentistry, you can dazzle the world with your smile.

Three of the biggest smile inhibitors are yellowing or discolored teeth, crooked teeth, and gaps. Each of these issues can be addressed by an American Academy of Cosmetic Dentistry (AACD) member dentist to give you the results you've dreamed of.

Teeth Whitening

There are a number of reasons why teeth become discolored over time from internal causes to external factors. So, it just makes sense that there are a variety of ways to deal with whitening, from simple do-it-yourself products to more extensive in-office treatments. While a prescription is not needed for the over-the-counter home remedies, it is a good idea to discuss them with your AACD dentist. In-office remedies are typically more effective and better for people with sensitivity issues because the rest of the mouth can be protected.

Crooked Teeth

While most people instantly picture teens in braces when they think of straightening crooked teeth, there are options for adults that are much more subtle than the full-metal braces of the past. Short-term orthodontics can include invisible braces that are placed behind the teeth and which can be a faster alternative to traditional braces; clear aligner therapy -- such as Invisalign -- a well-known "nearly invisible" treatment that uses trays to gradually create change; and more. With strict compliance, these solutions can create straighter teeth.

Gaps

Some gaps between teeth (diastema) can be fixed with the traditional metal braces or other short-term options mentioned above. But there are other methods of fixing gaps that can work almost instantly to give you a smile that you'll want to share. Bonding fills in the space by using a resin, and dental veneers use ceramic or porcelain to subtly widen the teeth to diminish the gap. If your gap is due to missing teeth or dental implants, a bridge or partial dentures can restore the healthy appearance you once had.

Talk to an AACD member dentist to find out which treatment(s) are best suited to tackling your smile-inhibitors and take your smile from blah to brilliant.  

By: NewsUSA for NewsUSA
http://www.mcdonoughvoice.com/news/20160928/how-to-overcome-your-smile-insecurities


If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

Maryland Bridge (Bonded Resin Retainer)

The Maryland bridge, or bonded resin retainer, is an alternative to implants and conventional crowns to replace missing teeth. This type of replacement procedure can be considered when the space to be restored is next to teeth in good alignment that are not heavily restored with filling materials. Because this type of bridge is adhesively bonded to the enamel on the abutment teeth, having adequate enamel is important. A Maryland bridge is fixed into place and is not meant to be removed at night.

Maryland Bridge vs. Fixed Bridge

One advantage of this process over a conventional bridge is that a missing tooth can usually be replaced with a minimum amount of preparation (drilling) of the remaining teeth. It is not necessary to prepare the tooth to the same extreme degree as with full tooth coverage restorations (crowns or caps). This method is an extremely conservative procedure. It is also less expensive (about one quarter less) than a conventional bridge. Tissue health around the abutment teeth is usually excellent because little or no preparation of the tooth structure near the gingival (gum) tissues is needed. Unlike conventional full coverage restorations, teeth prepared for a Maryland bridge retainer will not need endodontic treatment (root canal therapy) at a later date.

If the patient has abusive eating or bruxing (grinding) habits, this type of restoration is contraindicated. Although we do consider it more of a restoration for posterior (back) teeth rather than anterior teeth, it does display metal more so than a conventional bridge. The biggest disadvantage of a Maryland bridge is that the expected life may not be as long as that of a conventional bridge made of full coverage crowns. This technique was only introduced in the early 1980s and therefore does not have the extensive successful history of full coverage bridges. While breaking of a Maryland bridge is not likely, debonding can occur, requiring a re-cementation. In some rare instances, it might have to be redone. In either case, you may be charged a fee for the procedure. A Maryland bridge is a fixed replacement for a missing tooth, but one that will need to be redone in the future. The success rate at 5 years of Maryland bridges in our practice is approximately 80%. However, this is a much better result than the national average, which shows a success rate of about 33% at 4 years. Maryland bridges are most appropriate for single-tooth replacement. 

If dental implants are not an option for you for tooth replacement and you do not want the teeth on either side of the space to be radically prepared (cut down or drilled), then you should consider the Maryland bridge technique. For many patients, the advantages of less drilling of the teeth and the reduced cost make it a desirable alternative.

If you have any questions about the Maryland bridge technique, please feel free to ask us.