INDIRECT INTRA-

CORONAL
RESTORATIONS

(INLAYS & ONLAYS)

• Intra-cronal restorations are defined as
those surrounded by one or more
natural tooth surface(s)
Indirect restorations are those
that can not be fabricated
inside the mouth ,

Examples : crowns ,
bridges, inlays, onlays and
veneers
 INLAY
A fixed intracoronal restoration; a dental
restoration made outside of a tooth to correspond to the form of
the prepared cavity, which is then luted into the tooth

It restores the proximal and occlusal surfaces but does not

protect or cover the cusps.
 ONLAY

A restoration that restores one or more cusps and

adjoining occlusal surfaces or the entire occlusal surface and is retained
by mechanical or adhesive mean

It is used for restoring more extensively damaged posterior

teeth needing wide mesio-occluso-distal restorations.
 • Large restoration size wide facio-lingually
and require cusp coverage (difficulty in
obtaining proper contour, contact and
occlusion with direct restoration).
• Repeated fracture of direct restoration.
• Weak tooth structure with sound buccal
and lingual axial surfaces (want to be
I N D I C AT I O N S protected without extensive
preparation), e.g. Root treated posterior
tooth with damaged cusps especially
premolars (onlay).
• Removable Prosthodontic Abutment
• Esthetic (ceramic, processed composite).
 1. Insufficient tooth structure to
provide retention & resistance.
2• High caries rate
3• Young patients
4• Small restoration size
CONTRAIN 5• Heavy occlusal forces, bruxism,
D I C AT I O N S clenching (Ceramic restorations may
fracture when they lack sufficient
bulk).
 MATERIAL USED

metal Gold

Tooth Composite
coloured ceramic
 A DVA N TAG E S A N D D I S
A DVA N TAG E S O F G O L D

Advantages:-
• Strength (protect the
tooth from future fracture
injury) (onlay).
• Highly biocompatible.
• High wear resistance
(large restoration).
• High control of the
contour and contact.
Dis-advantages:-
• Number of
Appointments and Higher
Chair Time (except
CAD/CAM).
• Temporaries occasionally
loosen and or break
• Cost, more expensive
than direct restorations.
• Technique Sensitive.
 A DVA N TA G E S A N D
D I S A DVA N TA G E S
O F TO OT H
COLOURED
M AT E R I A L
Advantages
• Highly esthetic. Dis-advantages
• Improved physical • Increased cost and
properties when time
compared with the direct • Technique sensitivity.
restorations. • Brittleness of ceramics
• Wear resistance (A ceramic restoration can
• Reduced fracture if the preparation
polymerization shrinkage does not provide adequate
of indirect composite, thickness to resist occlusal
hence less post operative forces and/or if the
sensitivity micro leakage restoration is not
and discoloration. appropriately supported by
• Ability to strengthen the cement medium and the
remaining tooth structure preparation).
by adhesive bonding. • Wear of opposing
• More control of dentition and restorations
contours and contacts. (ceramic).
CLASS II INLAY
PREPARATION
 WHAT INSTRUMENTS DO I
NEED?

• Carbide burs OR Diamond stones

 OCCLUSAL ANALYSIS

• Start by marking the centric contact points.

• Avoid the margin of the restoration being too close to the

centric contact (≥ 1.0mm) to prevent damage to the
restoration.
 STEPS INVOLVED IN
CLASS II INLAY PREP.

An occlusal outline is prepared following

the central groove & extended
proximally
 ST E P S I NVOLV E D I N
CL ASS I I I NL AY P R E P.

• The tapered fissure

is oriented
perpendicular to an
imaginary line
connecting the facial
& lingual cusps.
The tapered fissure is oriented perpendicular to an imaginary line connecting
the facial & lingual cusps.
 STEPS INVOLVED IN CLASS II
INLAY PREP.

Depth 1.8 mm (just to the depth of the dentine)

STEPS INVOLVED IN
CLASS II INLAY PREP.

Gingival extension undermines the

marginal ridge while removing caries
 STEPS INVOLVED IN
CLASS II INLAY PREP.

Undermined enamel is removed with a

hand instrument & the walls of the
proximal box are defined. Contacts
with the adjacent tooth are removed.
STEPS INVOLVED IN
CLASS II INLAY PREP.

Occlusal bevel at the end of the

preparation
 STEPS
INVOLVED IN
CLASS II
INLAY PREP.

A gingivo axail groove is

placed with agingival
marginal trimmer
 STEPS
INVOLVED
IN CLASS II
INLAY PREP.
INTRA-CORONAL - INLAYS OR
FILLINGS

No undercut Undercut for

For inlay casting Plastic filling
 MESIO-
OCCLUSAL-
DISTAL ONLAY
PREPARATION
(MOD)
 ADVANTAGE
OF MOD
ONLAYS

• Occlusal forces are

distributed along the
base and pushs around
the tooth structure
sorrounding the MOD
inlay restoration
ADVANTAGE OF
MOD ONLAYS

This causes a wedging effect on the

tooth causing it to fracture
 ADVANTAGE OF MOD ONLAYS

• An onlay will distribute stress well

over a wide area reducing risk of
fracture
 STEPS INVOLVED IN MOD PREP.

• Steps of occlusal outline & proximal box prep. are similar to class
II inlay ecxept for the additional occlusal reduction & functional
cusp ledge.
 STEPS
INVOLVED
IN MOD
PREP.

Occlusal
outline,
proximal
box
extended
to remove
contacts.
 Unsupported
enamel
removed,
proximal boxes
defined to form
90 cavosurface
angles.
STEPS
INVOLVED IN
MOD PREP.

Occlusal reduction grooves

STEPS INVOLVED IN MOD PREP.

Occlusal reduction grooves

 STEPS INVOLVED IN MOD PREP.

Functional cusp bevel placed for distal half

 STEPS INVOLVED IN MOD PREP.

Functional cusp bevel gives restoration bulk in the higher stress area
 STEPS INVOLVED IN MOD PREP.

Compelet preparation