Reconstruction, inlay or crown - which treatment is right for me?

When there is a broken or decayed tooth, there are several restoration options, but... Do you know when each type is indicated and how they differ?

Reconstruction, inlays and crowns or caps are the treatment options we have to restore a damaged or weakened tooth. Each one is indicated for a specific type of case and all of them have a series of advantages and disadvantages, in this post we explain what they are.

Reconstruction

Reconstruction, also called filling or filling, consists of rebuilding the missing part of the tooth (due to breakage or after cleaning a cavity) with a composite resin, also known as composite. 

Picture above: caries in 4 teeth in a row
Image below: completed reconstructions

It is used in cases of minimal breaks or small, superficial cavities. It is the least resistant and least aesthetic of the three options. Its advantage is its lower price and it is also the option that requires the least dental preparation, i.e. the most conservative.

Inlay

When a reconstruction is going to be too big, because it affects several surfaces, or if we have to devitalise the tooth (kill the nerve or root canal) inlay is the most suitable option. It is a kind of ''little hat'' or ''cap'' that adheres to the tooth and usually contains in its composition a more resistant material than the composite such as lithium disilicate or zirconium oxide. 

Unlike the crown/onlay, the inlay does not require a 360° preparation, i.e. the tooth is not left as a ''stump''. It is therefore a more protective option than reconstruction, is more aesthetic and is not as invasive as a crown. In addition, there are modern digital scanning systems that allow the entire treatment to be completed in a single appointment.


Detail of three inlays on a white plaster model.

Crown

This is the most recommended option for badly destroyed teeth in which the other options do not ensure a good prognosis. It is a "sheath" that covers the entire tooth.

 A few years ago, conventional measurements were taken and made of ceramic-coated metal. The aesthetics and fit were not very good due to the fact that it was a handmade process. In addition, quite aggressive carving was required.

Nowadays, and with the advances in dentistry, things have changed. They are usually made of zirconium, a much more aesthetic material, and much less grinding is required so that, even if we drill 360º, we conserve much more of the tooth.

Therefore, as a disadvantage, it is the most invasive option (less conservative) and the least economical. On the other hand, it is the most resistant option due to the material in which they are designed.

After this, we can conclude that:

All three options are more than viable as long as they are chosen according to selection criteria. Your dentist will carefully study your case to decide which of them is the most favourable, always bearing in mind that the priority is to maintain as much healthy tooth tissue as possible.