Class II inlay
• The Class II inlay involves the
occlusal surface and one or
more proximal surfaces of a
posterior tooth.
Class II onlay
• When cusp tips are restored,
the term onlay is used.
Qualities of Casting Alloys
• High compressive strength
• High tensile strength
• Ductility
American Dental Association (ADA)
Specification No. 5 for Inlay Casting Gold:
• a minimum total gold-plus-platinum-metals-
content of 75 weight percent.
• Such traditional high-gold alloys are quite
unreactive in the oral environment and are
some of the most biocompatible materials
available to the restorative dentist
1. Biocompatibility
• material must tolerate oral fluids and not
release any harmful products into the oral
environment.
- biocompatibility of noble dental alloys is
primarily related to elemental release
from these alloys (i.e., their corrosion)
- any toxic, allergic, or other adverse
biological response is primarily influenced
by elements released from these alloys
into the oral cavity.
2. Corrosion resistance
• Corrosion is the physical dissolution of a
material in an environment.
Corrosion resistance:
1. Immune alloy system: components
being either too noble to react in the
oral environment (e.g., gold and
palladium)
2. Passivating alloy system: ability of one
or more of the metallic elements to form
an adherent passivating surface film,
which inhibits any subsurface reaction
(e.g., chromium in Ni-Cr and Co-Cr
alloys and titanium in titanium [CP Ti]
and in Ti-6Al-4V alloy).
• feature on single-phase composition: types
I, II, III
• two-phase compositions are prone to local
galvanic corrosion
3. Tarnish resistance
• Tarnish is a thin film of a surface deposit or
an interaction layer that is adherent to the
metal surface
4. Thermal properties
• must have closely matching thermal
expansion to be compatible with a given
porcelain, and they must tolerate high
processing temperatures
5. Melting range
• Dental casting alloys do not have melting
points, but rather melting ranges, because
they are combinations of elements rather
than pure elements. It is desirable for the
dental casting alloy to have a relatively
narrow melting range, because if the alloy
spends a long time in the partially molten
state during casting, there is increased
opportunity for the formation of oxides and
contamination.
• must be low enough to form smooth
surfaces with the mold wall of the casting
investment
6. Compensation for solidification
- compensation for casting
shrinkage from the solidus
temperature to room temperature
must be achieved either through
computer-generated oversized
dies or through controlled mold
expansion.
7. Castability
8. Economic considerations
Qualities of casting alloys
High density
- helps force the alloy quickly into the intricate
details of the pattern within the casting mold
before cooling solidifies the material. Gold-
based alloys are much better in this regard
than most other alloys.
Hardness is a good indicator of the ability of an
alloy to resist local permanent deformation
under occlusal load.
- If the hardness of an alloy is greater than
enamel, it may wear the enamel of the
teeth opposing the restoration
Low coefficient of thermal expansion helps
reduce the shrinkage that occurs from the
solidus temperature down to room
temperature. Because cooling produces
shrinkage, some expansion must occur
somewhere else in the technique sequence to
compensate for dimensional changes on
cooling. Alloys with low coefficients of thermal
contraction and that possess low melting
temperatures can be controlled more easily.
Four distinct groups of alloys:
1. the traditional high-gold alloys
2. low-gold alloys: 3-50% gold or other noble
metals
3. Gold substitute alloys precious metals that
do not contain gold: silver-palladium alloys
4. base metal alloys: corrodes but develop
corrosion resistance by surface oxidation
the traditional high-gold alloys
• Type I, II, III, IV (Au, Ag, Pt, Pd, Cu)
• Type I contains 80-90% gold, II has 75-78%, III
has 62-78%, and IV has 60-70%.
• Types I and II cannot be heat treated
• Type I: (low stress) small occlusal inlay with no
significance can’t occlusal load.
• Type II (moderate stress) are for inlays and
onlays
• Type III (high-stress) for onlays and crowns,
short span FPD
• Type IV (very high stress) for crowns, bridges
and RPD frameworks, long span FPD
base metal alloys:
• Formulated with 18-28% chromium to
produce chromium oxide ( Cr2O3) that
passivates the surface of metal
• Chromium oxide is brittle and may fracture
but reforms easily if chromium remains in the
composition
COMPONENTS
Gold:
• Corrosion resistance.
• deformability (ductility).
• Ranks lowest in strength and is soft so other
metals are added to solution-harden the
alloy
• Copper is commonly added to increases
the hardness of the alloy
• Characteristic yellow color with a strong
metallic luster.
• Density (Sp gravity) 19.3 g/cm3.
• Tarnish resistance.
• Fusion temperature – 1063o C.
Silver:
• It contributes to the strength and hardness
of the alloy.
• Although it mimics gold in its deformability
effect, it adversely affects the malleability
and it lowers tarnish resistance.
• Food containing sulfur compounds, cause
severe tarnish on silver.
• Silver serves to balance the red color given
by copper.
• Adding small amounts of palladium to silver
containing alloys prevents the rapid
corrosion of such alloys in the oral
environment
Copper:
• Contributes strength and hardness, but
decreases the malleability of the alloy, i.e., it
decreases the tarnish and corrosion
resistance.
• The content should not exceed 16%.
• Gives the alloy reddish appearance.
• Lowers the fusion temperature.
Zinc: (Present only in low percentages, around
0.5%)
• Blue-white metal that can tarnish in moist air.
• Acts as a deoxidizer and reduces the
oxygen content (because O2 released
during solidification results in porosity).
Nickel
• Nickel has limited application in gold- and
palladium- based dental alloys, but is a
common component in base-metal dental
alloys.
• nickel whitens the alloy and increases its
strength and hardness
Platinum: Bluish-white metal. Tough, ductile,
malleable May be added to
1. Strengthen the alloy and increase the
hardness of alloy
2. Raise the fusion point (1755).
3. Import rigidity, nobility and hardness.
4. Whiten the alloy.
5. Specific gravity-- 21.37.6.
6. Together with palladium, platinum
increases melting range of alloy.
Palladium: white metal but darker than
platinum.
• Serves the same functions but is much less
expensive than platinum.
Iridium, Ruthenium and Rhodium:
• Trace amounts of these metals are added
as “Grain Refiners” melting point
• As little as 0.005% is sufficient to refine the
grain size. Grain refiners produce smaller
grains.
• Fine-grained alloys are generally stronger
and more ductile than coarse- grained
alloys.
• Indium can also act as a scavenger for the
alloy during casting procedure. Also serve to
increase the tarnish and corrosion
resistance.
INDICATIONS
(1) Large restorations
• Alternative to amalgam or composite when
higher strength of material is needed
• Superior contours and contacts are needed
• Cast onlay is an alternative to crown if facial
and lingual surfaces are unaffected
• Onlays can be designed to distribute
occlusal loads over the tooth to prevent
fracture
(2) Endodontically treated teeth
• Molars/ premolars treated with RCT can be
restored with a cast metal onlay
(3) Teeth at risk for fracture
• Teeth with fracture lines in enamel and
dentin, especially with extensive restorations
can be restored with onlays and crowns.
(4) Dental Rehabilitation with Cast Metal Alloys
• use of the same material may be
considered to eliminate electrical and
corrosive activity that sometimes occurs
between dissimilar metals in the mouth
• cast inlay or onlay is indicated when
extension of the mesiodistal dimension of the
tooth is necessary to form a contact with an
adjacent tooth
• onlays also can be used to correct the
occlusal plane of a slightly tilted tooth
(5) Removable Prosthodontic Abutment
• Abutment teeth for RPD can be restored
with cast metal restoration because
(1) The superior physical properties of the
cast metal alloy allow it to better
withstand the forces imparted by the
partial denture
(2) the rest seats, guiding planes, and other
aspects of contour relating to the partial
denture are better controlled when the
indirect technique is used.
CONTRAINDICATIONS
1. High caries rate- presence of smooth
surface caries indicates high caries activity,
indirect metal resto must be placed after
caries is brought under control
2. Young patients- direct restorative materials
- indirect procedure requires longer and
more numerous appointments, access is
more difficult, the clinical crowns are
shorter, and younger patients may
neglect oral hygiene, resulting in
additional caries.
3. Esthetics- not on tooth surfaces that are
visible at a conversational distance
4. Small restorations- high success rate of
using amalgam and composites on small
restorations
Advantages
1. Strength
2. Biocompatibility
3. Low wear rate
4. Control of contours and contacts
Disadvantages
1. Need for temporary restoration
2. Requires temporary restorations
3. Cost
4. Technique sensitive
5. Splitting forces - inlays may produce
wedging effect on facial and lingual tooth
structure and increase the potential for
splitting the tooth
Significant clinical properties:
• close fit: if the cemented restorations have a
close fit (within 20 μm), and the tooth
preparations are adequately designed, the
conventional dental cements resist
degradation and provide excellent
retention and service for 20 to 40 years
• corrosion: gold- based alloys exhibit
excellent corrosion resistance for at least 10
years. [Morris)
• retention: internal surfaces are sandblasted,
sufficient micromechanical irregularities are
produced to permit excel- lent luting
CLINICAL TECHNIQUE
CLINICAL TECHNIQUE
1. Occlusal step
• With the No. 271 or 69L carbide bur held
parallel to the long axis of the tooth
crown, enter the fossa/pit closest to the
involved marginal ridge, using a punch
cut to a depth of 1.5 mm to establish the
depth
• pulpal floor and gingival walls must be
flat
Features of cavity preparation:
1. TAPER
- the cutting instruments used to develop
the vertical walls are oriented to a single
"draw" path, usually the long axis of the
tooth crown, so that the completed
preparation will have draft (no undercuts).
- Taper: 2-5 degrees
- If occlusogingival height is short: MAXIMUM
OF 2° TAPER IS DESIRED
- gingival-to-occlusal divergence of these
preparation walls may range from 2 to 5
degrees per wall from the line of draw.
- If the vertical walls are unusually short, a
maximum of 2 degrees occlusal
divergence is desirable to increase
retention potential.
 - If occlusogingival height is LONG:
INCREASE OF DEGREE OF TAPER IS DESIRED
because engthy preparations with minimal
divergence (more parallel) may present
difficulties during the seating and
withdrawal of the marginal restoration
- A general rule is to maintain the long axis
of the bur parallel to the long axis of the
tooth crown at all times
- As the occlusogingival
height increases, the
occlusal divergence
should increase because
lengthy preparations with
minimal divergence may
present difficulties during
pattern withdrawal, trial
seating and withdrawal of
the casting, and
cementing.
- Mandibular molars and second premolars
whose crowns tilt slightly lingually, this rule
dictates that the bur should tilt slightly (5 to
10 degrees) lingually to conserve the
strength of the lingual cusps
2. DEPTH
• Shallow (0.3 mm deep) retention grooves
may be cut in the facioaxial and
linguoaxial line-angles with the No. 169L
carbide bur
Proximal Box
• Ideal extension gingivally of a minimal,
cavitated lesionwill eliminate caries on the
gingival floor
• 0.5-mm clearance of the unbeveled
gingival margin
• Shallow (0.3 mm deep) retention grooves
may be cut in the facioaxial and linguoaxial
line-angles with the No. 169L carbide bur
3. PULP PROTECTION
• LIGHT CURED GLASS IONOMER
• PULP CAPPING
• If base is used, coating of the surface with
petroleum jelly is advised.
PULP CAPPING
• The exposure is small (less than 0.5 mm in
diameter).
• The tooth has been asymptomatic
• hemorrhage is easily controlled.
• The invasion of the pulp chamber was
relatively atraumatic with little physical
irritation to the pulp tissue.
• Clean, uncontaminated operating field is
maintained
Remaining old restorative material on the
internal walls should be removed if any of the
following conditions are present:
1) the old material is judged to be thin and/or
non-retentive
2) there is radiographic evidence of caries
under the old material
3) the pulp was symptomatic preoperatively
4) the periphery of the remaining restorative
material is not intact
Occlusal bevels
• width of the cavosurface bevel on the
occlusal margin should be approximately
one fourth the depth of the respective wall
gingival margin
• resulting occlusal marginal metal of
• the inlay should be 40- degree metal; thus
the occlusal marginal enamel is 140-degree
enamel

4. BEVELS AND FLARES

• slender, flameshaped, fine- grit diamond
instrument is used to bevel the occlusal and
gingival margins and to apply the
secondary flare on the distolingual and
distofacial walls.
• This should result in 30- to 40-degree
marginal metal on the inlay

Secondary flare
The secondary flaring of the proximal walls :
• extends the margins into the embrasures,
making these margins more selfcleaning
and more accessible to finishing procedures
during the inlay insertion appointment, and
does so with conservation of dentin
The gingival bevel serves the following
• the flare results in 40degree marginal metal
purposes:
that is burnishable
1) Weak enamel is removed. • A more blunted and stronger enamel
2) If the gingival margin is in the enamel, it margin is produced because of the
would be weak secondary flare.
3) The bevel results in 30-degree metal that is
burnishable
4) A lap, sliding fit is produced at the gingival
margin
External outline form
• should consist of straight lines and smooth
following curves, avoiding any short angles.
• Cavosurface margin placed is placed on
sound, unbroken tooth tissue to obtain a well
fitting casting.
• Placement of bevels make the outline form
slightly wider.
• the pulpal floor and the axial wall of the
inlay preparation should be placed in the
dentin and care should be taken to protect
the pulp.
• Line angles in both occlusal and proximal
portions of the preparations should be well
defined and the axio-pulpal line angle
What is capping of cusp?
slightly rounded.
• When the occlusal outline is extended up
the cusp slopes more than half the distance
Outline form from any primary occlusal groove (central,
• Depth of the cavity is 1.75 to 2 mm from the facial, or lingual) to the cusp tip, capping
central groove. the cusp should be considered. If the
• Long axis of 271 bur is held parallel to long preparation outline is extended two thirds of
axis of tooth crown at all times. this distance or more,
• For mandibular molars and premolars the
bur is tilted 5-10° lingually to conserve the
strength of lingual cusp.

Resistance and retention form

• Parallel opposing walls aids in retention.
• Flat pulpal and cervical floors – resistance
form.
• Well defined angles help in maintaining
precise relationship between restoration and
tooth tissue improving retention and
resistance.
• Divergent walls – 2-6° taper increased in
case of deeper cavity but not exceeding
10°.
• Axiopulpal line angle rounded to dissipate Rationale for capping the cusp:
stress equally. Capping the cusp is usually necessary to:
• Occlusal dovetail or interlock prevents 1) protect the weak, underlying cuspal
proximal displacement of restoration. structure from fracture caused by
• If no proper parallelism or no proper depth masticatory force and
of cavity is there then secondary retentive 2) remove the occlusal margin from a region
devices like slots and pinholes can be given. subjected to heavy stress and wear
• Shallow retentive grooves, 0.3mm deep, At this point in preparation the pulpal floor,
maybe given on buccoaxial and linguoaxial depth can be increased from 1.5 mm to 2 mm.
line angles. – indicated when preparation is
shallow.
CLASS II CAST METAL ONLAY
Skirting
Skirts are thin extensions of the facial or lingual
proximal margins of the cast metal onlay that
extend from the primary flare to a termination
just past the transitional line angle of the tooth.
• A skirt extension is a conservative method of
improving both the retention form and the
resistance form of the preparation.
• It is relatively atraumatic to the health of the
tooth because it involves removing very little
dentin.
• Usually the skirt extensions are prepared
entirely in enamel.
FULL ONLAY
The FULL ONLAY by definition
caps all of the cusps of a
posterior tooth and can be
designed to help strengthen a tooth that has
been weakened by caries or previous
restorative experiences.
FULL ONLAY vs CROWN
• help strengthen a tooth that has been
weakened by caries or previous restorative
experiences distribute occlusal loads over
the
• tooth in a manner that greatly decreases
the chance of future fracture
• more conservative of the tooth structure
than the full crown preparation
• supragingival margins, when possible, are
less irritating to the gingiva.
FULL ONLAY
• Using the No. 271 carbide bur held parallel
to the long axis of the tooth crown, a 2mm
deep pulpal floor is prepared along the
central groove
Temporization
1. It should be nonirritating and protect the
prepared tooth from injury.
2. It should protect and maintain the health of
the periodontium.
3. It should maintain the position of the
prepared, adja- cent, and opposing teeth.
4. It should provide for esthetic, phonetic, and
mastica- tory function, as indicated.
5. It should have adequate strength and
retention to withstand the forces to which it
will be subjected.
Indirect Temporary Restoration
1. The indirect technique avoids the possibility
of “locking on" the set temporary material
into undercuts on the prepared tooth or the
adjacent teeth.
2. The indirect technique avoids placing
polymerizing temporary material directly on
freshly prepared dentin and investing soft
tissue, reducing potential irritation to these
tissues.8-10
3. The post-operative cast made in the
indirect technique affords an opportunity to
evaluate the preparation (before the final
impression) and serves as an excellent
guide when trimming and contouring the
temporary restoration.
4. Fabrication of the temporary restoration
can be dele- gated to a well-trained
dental auxiliary.

Direct Temporary Restoration

• involves fewer steps and materials because
no postoperative impression and gypsum
cast are required
• much faster than the indirect technique. The
main disadvantages of the direct temporary
technique include the following:
• There is a chance of locking hardened
temporary materials into small undercuts on
the prepared tooth and the adjacent teeth,
• the marginal fit may be slightly inferior to the
indirect technique
• it is more difficult to contour the temporary
restoration without the guidelines offered by
the postoperative cast