What is an inlay and in which cases is it recommended?

What is a dental inlay?

If you have arrived here, it is probably because you have already read the word inlay in a quote or a professional has mentioned it to you and you have several questions that we are going to try to answer. An inlay is a way of covering the tooth integrally or partially, to give it stability and durability over time. With it we can restore the tooth both functionally and aesthetically. It usually comes from a milled block.

It is also a concept that will help us to convey how we work at Vélez & Lozano and why we do it that way. In the past, when a tooth was sufficiently damaged (not too badly), the most common thing to do was to extract it. However, over time, dentistry has increasingly opted for more conservative methods.

This is where the dental inlay comes in.

In which cases do we use an embedding?

When a patient comes to the clinic with a "cracked tooth" (in their own words), what any dentist would do is look for a cavity, as this is the most common reason why a tooth can suffer a fracture. And when thinking of a cavity, it is normal to think of a filling (or a 'filling', rather), but often, after cleaning the cavity, the tooth that remains free of infection is insufficient for a normal, functional life, and it is in this case when inlays and onlays come into play.

Do you now understand why this type of tooth used to be extracted? It is not because dentists wanted to make life easier for themselves and because removing the tooth was much simpler, but because there was no way to save such a deeply affected tooth.

On other occasions, the tooth that has broken, usually by eating something excessively hard or soft (in the latter case the tooth was actually already broken, but it remained embedded, and by eating something sticky the traction forces manage to pull the 'piece' out), because it is already excessively restored. A tooth that has had several fillings in different areas, leaving very thin tooth walls that are prone to break when occlusal forces are applied, especially if the fillings on which the forces are applied are old and defective. This happens because the hardness of a tooth is not the same as that of the composite, which is why after a few years these misalignments are created, as they do not wear down at the same rate. For this reason, when a tooth is excessively restored, it is also ideal to resort to an inlay.

Other times, after a root canal, either because it is associated with a very large restoration due to caries or fracture or simply because in order to perform the procedure itself it is necessary to 'remove' a piece of healthy tooth, it is usual to place an inlay. Otherwise, it will be difficult to maintain the integrity of the tooth, weakening it much more and increasing its chances of fracture sooner or later.

And how is embedding done?

By now you're probably wondering what exactly an inlay is. You'd better take a look at this video:

As you can see, the inlay itself is the piece that rehabilitates the area that is missing from the tooth once the caries has been cleaned. They can be made in different types of material: pure ceramic, ceramic with resin, ceramic with zirconium, pure resin...etc.

Advantages of embedding

-Decreases the possibility of dental fracture.

-It promotes the creation of good contact points on excessively destroyed teeth, which we cannot always do with a filling if it is too large.

-When milled from a block, it has a much higher hardness than conventional fillings, so it withstands more chewing forces over time.

-The mimicry achieved with the tooth is spectacular.

-It is a more conservative option than the more common crowns, as they are bonded almost like a composite filling, it is not necessary to reduce the tooth other than to leave space for the thickness of the material, which is minimal.

And why did my dentist recommend a crown instead of an inlay?

Sometimes the tooth has already been ground down by a previous crown, or is so badly destroyed, that the possibility of inlaying it and having it function over time without causing problems is unfeasible. In these cases, before extracting the tooth, it is sometimes possible to restore it with crowns or posts, although this is up to the dentist to decide.