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  • Gold inlay on a molar tooth


    flag UK In dentistry, an inlay is usually an indirect restoration (filling) consisting of a solid substance (as gold, porcelain or less often a cured composite resin) fitted to a cavity in a tooth and cemented into place.
    This technique involves fabricating the restoration outside of the mouth (by a dental technician) using the dental impressions of the prepared tooth, rather than placing a soft filling into the prepared tooth before the material sets hard.
    An onlay is the same as an inlay, except that it incorporates a replacement for a tooth cusp by covering the area where the missing cusp would be.
    Crowns are onlays which completely cover all surfaces of a tooth. See below...

    Comparison of inlays and direct fillings
    When an inlay is used, the tooth-to-restoration margin may be finished and polished to a very fine line of contact to minimize recurrent decay.
    Opposed to this, direct composite filling pastes shrink a few percent in volume during hardening. This can lead to shrinkage stress and rarely to marginal gaps and failure.
    Although improvements of the composite resins could be achieved in the last years, solid inlays do exclude this problem.
    Another advantage of inlays over direct fillings is that there is almost no limitations in the choice of material.
    While inlays might be ten times the price of direct restorations, it is often expected that inlays are superior in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers.
    However, this might be only the case for gold. While short term studies come to inconsistent conclusions, a respectable number of long-term studies detect no significantly lower failure rates of ceramic or composite inlays compared to composite direct fillings.
    Another study detected an increased survival time of composite resin inlays but it was rated to not necessarily justify their bigger effort and price.

  • Crowns in dentistry

    flag UK In dentistry, crown refers to the anatomical area of teeth, usually covered by enamel.
    The crown is usually visible in the mouth after developing below the gingiva and then erupting into place. If part of the tooth gets chipped or broken, a dentist can apply an artificial crown.
    Crowns are used most commonly to entirely cover a damaged tooth or cover an implant. Bridges are also used to cover a space if one or more teeth is missing. They are cemented to natural teeth or implants surrounding the space where the tooth once stood.
    There are various materials that can be used including a type of cement or stainless steel.
    The cement crowns look like regular teeth while the "stainless steel" crowns are silver or gold.
    A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant. Crowns are often needed when a large cavity threatens the ongoing health of a tooth.
    They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods.
    Crowns are often used to improve the strength or appearance of teeth.
    While inarguably beneficial to dental health, the procedure and materials can be relatively expensive.
    The most common method of crowning a tooth involves using a dental impression of a prepared tooth by a dentist to fabricate the crown outside of the mouth.
    The crown can then be inserted at a subsequent dental appointment.
    Using this indirect method of tooth restoration allows use of strong restorative materials requiring time-consuming fabrication methods requiring intense heat, such as casting metal or firing porcelain which would not be possible to complete inside the mouth.
    Because of the expansion properties, the relatively similar material costs, and the cosmetic benefit, many patients choose to have their crown fabricated with gold.
    As new technology and materials science has evolved, computers are increasingly becoming a part of crown fabrication, such as in CAD/CAM dentistry.

  • Dental Bridge

    flag UK A bridge is a fixed dental restoration (a fixed dental prosthesis) used to replace a missing tooth (or several teeth) by joining an artificial tooth permanently to adjacent teeth or dental implants.

    Types of bridges may vary, depending upon how they are fabricated and the way they anchor to the adjacent teeth.
    Conventionally, bridges are made using the indirect method of restoration.
    However, bridges can be fabricated directly in the mouth using such materials as composite resin.
    A bridge is fabricated by reducing the teeth on either side of the missing tooth or teeth by a preparation pattern determined by the location of the teeth and by the material from which the bridge is fabricated.
    In other words, the abutment teeth—including portions which are otherwise perfectly healthy—are "reduced" in size using a high-speed rotary tool to accommodate the material to be used to restore the size and shape of the original teeth in a correct alignment and contact with the opposing teeth.
    The dimensions of the bridge are defined by Ante's Law: "The root surface area of the abutment teeth has to equal or surpass that of the teeth being replaced with pontics".
    The materials used for the bridges include gold, porcelain fused to metal, or in the correct situation porcelain alone.
    The amount and type of reduction done to the abutment teeth varies slightly with the different materials used.
    The recipient of such a bridge must be careful to clean well under this prosthesis. When restoring an edentulous space with a fixed partial denture that will crown the teeth adjacent to the space and bridge the gap with a pontic, or "dummy tooth", the restoration is referred to as a bridge. Besides all of the preceding information that concerns single-unit crowns, bridges possess a few additional considerations when it comes to case selection and treatment planning, tooth preparation and restoration fabrication.

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