SEMINAR -inlay cavity designs

1. 1

2. Inlay Cavity Designs
Guided by
Dr.T.Rambabu
professor
Presented by
V.Naga Lakshmi
I MDS
2

3. Contents
 Introduction
 Definitions
 Indications
 Contraindications
 Inlays for
cast metal restorations
composites
ceramics
3

4.  Different modifications
 Conclusion
 References
4

5. INTRODUCTION
Dr.Philbrook in 1897 was the first to introduce inlay
in dentistry who gave the concept of forming an
investment around a wax pattern, eliminating the
wax, and filling the resultant mold with a gold alloy.
In 1907 Taggart changed the practice of restorative
dentistry by introducing his technique for cast gold
dental restorations.
5

6. Definition
 Inlay: an inlay is an indirect intracoronal restoration
fabricated using the lost wax technique.
 Class II inlay: An inlay is primarily an intracoronal
restoration that is designed extraorally mainly to
restore occlusal and proximal surfaces of a posterior
tooth and may cap one or more, but not all, of the
cusps.
6

7. Indications
A cavity’s width does not exceed one-third of the
intercuspal distance.
Strong, self-resistant cusps remain.
Indicated teeth have minimal or no occlusal facets and,
if present, are confined to the occlusal surfaces.
The tooth is not to be an abutment for a fixed or
removable prosthesis.
Occlusion or occluding surfaces are not to be changed by
the restorative procedure.
MARZOUK
7

8. Contraindications
 Developing and deciduous teeth
 High plaque/ caries indices.
 Esthetics.
8

9. Materials for cast restorations
According to Marzouk:
 Class I: gold and platinum-group based alloys.
 Class II: low gold alloys, with gold content less
than 50 %. Some may contain as less as 5% gold.
 Class III: these are non-gold palladium based
alloys
 Class IV: nickel- chromium based alloys.
 Class V: castable, moldable ceramics.
9

10. Instrumentation for class II
inlay preparation
 Suggested burs: no.271 & no.169L
burs.
 Generally plane cut, tapered
fissure burs.
 Enamel hatchets- for mandibular
preparations.
 Binangle chisels- for maxillary
preparations to remove irregular
proximal dentin and complete the
box form.
169 l bur
271 bur
10

11.  Margin trimmers: to provide the gingival bevels.
 Small flame-shaped diamond or 12 fluted carbide
finishing burs- for gingival bevels and also occlusal.
 Sandpaper disks: 3/8 or ½ inch cuttle-fish sand
paper disk to smooth the facial and lingual walls of
the proximal preparation.
 Instrumentation for finishing: A sharp wedelstaedt
chisel – final smoothening of the margins.
11

12. Prior to the removal of any calcified tissue, the tooth
must be studied carefully for the factors that influence
the design of the cavity to be prepared.
1.Length of the clinical crown.
2.Anatomic characteristics of the occlusal, proximal,
buccal and lingual surfaces.
3. Position of the tooth in the arch.
4.Occlusal and proximal relationships.
5.Relationship and condition of the soft tissues.
6.Extent and location of the carious lesion.
12

13. General Principles of cavity – tooth
preparation for cast restorations
A. Preparation path: single
insertion path. This path should
be opposite to the direction of
occlusal loading, so that function
will seat the restoration rather
than displace it.
B. Apico-occlusal taper of a
preparation: on average 2-5 °
from the path of preparation.
13

14. It can be decreased or increased
according to the following
factors:
1.Length of the preparation wall
and /or axial surfaces.
Greater the wall length- greater
is the taper, but not to exceed
more than 10°.
14

15. 2. Dimensions and details of surface involvement and
internal anatomy in the preparation:
greater the surface involvement and more detailed the
internal anatomy is, the greater will be the frictional
component between the materials and the preparation
contacting it.
3. The need for retention: the greater the need for
retention is, the more will be the need to approach exact
parallelism.
15

16. c. Preparation features of the circumferential tie:
peripheral marginal anatomy of the preparation.
It should have following features as advocated by Noy : if
the margin ends on enamel:
Enamel must be supported by sound dentin.
Enamel rods forming the cavosurface margin should be
continuous with sound dentin.
Enamel rods forming the cavosurface margins must be
covered with the restorative material.
For occlusal and gingival walls: In the form of bevels.
16

17. Types and design features of occlusal
and gingival bevels
Slender, flame shaped, fine grit diamond instrument is
used to bevel the occlusal and gingival margins.
Results in 30-40 degree marginal metal on the inlay.
And strong enamel margin of 140-150°.
The gingival bevel should be 0.5-1mm wide and should
blend with any secondary flares.
17

18. Gingival bevels
Serves the following purposes:
 Weak enamel is removed
 The bevel results in 30-degree metal that is
burnishable
 A lap,sliding fit is produced at the gingival
margin.
 Bevels allow direct frictional contact
between the inlay and the tooth.
18

19. Occlusal bevels
Is a long bevel constituting almost 1/3rd of the facial and
lingual walls.
bevelled outer plane of walls will have an angulation of 30-
45° to the long axis of the crown.
The angulation of the bevel should decrease with
increased steepness of the cusps.
 Width of the cavosurface bevel on the occlusal margin
should be approximately ¼ th the depth of the
respective wall.
19

20.  Angles- 40° metal and 140°
tooth enamel.
 Increases the strength of
the marginal enamel and
helps seal and protect the
margins.
Finally metal at the occlusal
margin-40°.
And at the gingival margin -30°.
20

21.  According to their shapes and types of tissue
involvement there are six types of bevels:
1. Partial bevel: part of enamel wall, not exceeding two-
thirds of its dimension.
2. Short bevel: entire enamel wall, but not dentin.
3. Long bevel: all of the enamel wall and half of the
dentinal wall.
21

22. 4. Full bevel: all of the dentinal and enamel walls of the
cavity wall or floor.
5. Counter bevel: when capping cusps to protect and support
them, this type of bevel is used, opposite to an axial cavity
wall, on the facial or lingual surface of the tooth, and it will
have a gingival inclination facially or lingually.
22

23. 6. Hollow-ground bevel: this allows more space for material
bulk, a design feature needed in special preparations to
improve materials castability retention and better
resistance to stresses.
23

24. Types and design features of
facial and lingual flares
 Two types of flares:
Primary flare: conventional and basic part of the
circumferential tie facially and lingually for an
intracoronal preparation.
Makes the facial and lingual margins of the cavity
preparation to cleansable-finishable areas.
24

25.  Secondary flare: almost always a flat plane superimposed
peripherally to a primary flare.
 Secondary flares may have different angulations,
involvement and extent depending on their function.
 Indications:
In very widely extended lesions bucco- lingually,.
Very broad contact areas or malposed contact areas.
25

26.  Secondary flare is necessary for:
Extends the margins into the embrasures, making
these margins more self-cleaning and more
accessible to finishing procedures.
Direction of the flare results in 40° marginal metal
that is burnishable.
A more blunted and stronger enamel margin is
produced because of the secondary flare.
26

27. Principles of cavity preparation
 Initial preparation:
Occlusal step: 271 bur held parallel to the long axis of
the tooth , entry is gained into the pit/fossa closest to
the involved marginal ridge, using a punch cut to a depth
of 1.5mm to establish pulpal wall.
The ideal occlusal depth is 1mm into dentin or 2.5mm at
the triangular ridges.
The facial and the lingual extension in the uninvolved pit
region should provide he desired dovetail retention form,
which resists the displacement in the opposite direction.
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28.  General rule: to maintain the long axis of the bur parallel to
the long axis of the tooth crown at all times.
28

29.  Continuing at the initial depth, the occlusal step is
extended into the involved marginal ridge sufficiently
to expose the junction of the proximal enamel and
the dentin.
 The increased facio-lingual width – facial & lingual
walls of the box projects perpendicular to the
proximal surfaces.
 Clearance with the adjacent tooth – 0.2-0.5 mm.
 Isthmus should be only slightly wider than the bur.
29

30.  Proximal box: proximal ditch cut- no 271 bur.
 Mesiodistal width of the ditch-0.8 mm.
 2/3rd at the expense of dentin(0.5) and 1/3rd at the
expense of enamel.(0.3).
 Ideal extension gingivally of a minimal cavitated lesion –
provides clearance 0.5 mm clearance of the unbeveled
gingival margin with the adjacent tooth.
 Two cuts are made- one at the facial limit of the
proximal ditch and the other at the lingual limit,
perpendicularly towards the enamel surface.
30

31.  In the proximal portion of the inlay cavity preparation,
the axial wall should either be flat or slightly rounded in
the bucco-lingual direction and either vertical or slightly
divergent towards the pulpal floor in the gingiva-occlusal
direction.
 proximally, the facial and lingual walls are comprised of
two planes.
In the axial half it is formed completely of dentin and
meets the axial wall at a right angle relationship.
The proximal half of the facial and lingual walls is formed
of a primary flare comprised of enamel and dentin with an
unchanged 45° angle to the wall proper.
31

32. Sometimes it is necessary to impose a third plane in
the form of a secondary flare, placed on enamel
peripherally.
Gingival floor proximally should be flat in the bucco-
lingual direction, making slightly obtuse angle with the
buccal and lingual walls.
In the axio-proximal direction it is formed of two
planes. Axial half consists of gingival wall proper that is
perfectly flat, formed of dentin and making either a
right or a slightly obtuse angle with the axial wall.
32

33.  In the axio-proximal direction it is formed of two
planes. Axial half consists of gingival wall proper
that is perfectly flat, formed of dentin and making
either a right or a slightly obtuse angle with the
axial wall.
 The gingival floor of the box should have an axial
depth of approximately 1-1.5mm.
 Ideally the gingival extension should be established
occlusal to the height of the papilla.
33

34. The proximal half should be bevelled in the form of a long
bevel inclining gingivally. Average of 30-45 to the wall
proper.
The junction between the occlusal bevel and the secondary
or primary flare proximally, and also the junction between
the primary or secondary flares proximally and the
gingival bevel should be very rounded and smooth.
34

35.  Depending on access, straight chisel, binangle
chisel or enamel hatchet is used to remove all
undermined and weakened structure.
 Shallow 0.3 mm deep retention grooves may be cut
in the facioaxial and linguo-axial line angle with 169
L carbide bur.
35

36.  Outline form
External outline form:
External outline form for inlay should consist of straight
lines and smooth flowing curves avoiding any short angles.
The finishing line should be extended on to the occlusal,
proximal and cervical areas until the carious lesion is
removed and the margins are convenient for finishing of
the preparation as well as for casting.
36

37.  Enamel rods at the cavosurface margin should be
supported by dentin.
 The placement of bevels makes the outline form
slightly wider for cast restorations.
37

38. Internal outline form
 Pulpal floor and the axial wall lie in the dentin.
 Care must be taken to protect the pulp.
 When the preparation has to be taken beyond its usual
internal limits, appropriate cement base has to be applied.
 Amount of taper varies…. With the length.
 Pulpal floor will usually be positioned 0.5 mm into the
dentin below the central groove (1.75- 2mm).
 The cervical floor is positioned after the caries removal.
 Axio-pulpal line angle is slightly rounded.
 The flare of the proximal walls should form axioproximal
angle of 100-110°.
38

39.  In some cases it is desirable to incline the cutting
instrument so that it forms an exaggerated taper from
cavosurface to pulpal floor or a long bevel on that area
of the wall.
 This protects the thin wall of the enamel that remains
at the cavosurface by maintaining a supporting edge of
dentin.
39

40. Resistance and retention form
 The design must take into
consideration occlusall forces that
may cause fracture of the tooth.
 Depends on
Inlay taper:
“ concept of taper”
“line of draw”: describes the path of
insertion and removal of the casting and
is the axis of the taper.
40

41.  “Cone angle taper”: describes the total relationship of all
prepared walls of the cavity.
 Axial length α amount of taper.
 Pulpal and cervical floors should ideally be perpendicular
to the lines of force .
 Well-defined line angles will help in providing precise
relationship between restoration and tooth tissue.
41

42.  The slice is frequently used to increase the
resistance and retention form by exposing a
larger amount of tissue surface to the frictional
grasp of the restoration.
 The occlusal interlock or dovetail prevents it
from being displaced laterally.
42

43. Factors affecting retention of cast
restorations
 Geometry of the tooth preparation
1.taper
2.surface area.
3. stress concentration.
4. type of preparation.
 Roughness of the surfaces being cemented.
 Materials being cemented.
 Type of luting agent.
43

44. Additional retention and resistance
forms
 Retention grooves: axioproximal grooves are
required when the wall dimensions are less.
(shallow cavities).
44

45. Additional retention and resistance forms
 Internal box: when occlusal dovetail is doubtful to
provide adequate retention , an internal box prepared
on the pulpal floor just adjacent to the uninvolved
marginal ridge improves the retention form.
45

46.  Reverse bevel: this is a bevel placed on the gingival
seat directed towards the axial wall. Helps to lock the
proximal portion of the restoration and prevents
proximal displacement.
46

47.  Skirts: these are the extensions from the primary
flare onto the facial and lingual surfaces slightly
beyond the axial angles of the tooth.
47

48.  Collar: surface extension completely
surrounding a cusp or a surface of a tooth.
On facial or lingual surfaces of the cusps
during cusp capping.
48

49. Convenience form
 Opening the preparation to its approximate final outline
form to establish an intact dentinoenamel junction
enhances access and visibility for removal of carious
dentin or old restorative materials.
 Extension, taper and flare of proximal walls to permit
access for disking and bevel placement, and extension to
allow proper finishing and adaptation of margins of
restorative material.
49

50. Finishing enamel walls and
margins
 Margins should be finished with carbide finishing burs or
fine abrasive disks.
 Cervical bevel- flame shaped extra fine finishing bur or
flame shaped extra fine grit finishing diamond point or
gingival marginal trimmers.
 Direct wax pattern- the bevel used is of greater bulk and
extends a greater width across the cervical floor. Thus a
cervical bevel should be uniformly about ¼ to ½ of the m-
d width of the cervical floor .
50

51. Cleaning and critical appraisal of
the cavity
 A trial impression with gutta-percha or impression
compound – to evaluate the taper and the line of draw
of the preparation.
51

52. Variations in proximal marginal
design
 Depends on the following factors:
Extent of tooth tissue loss.
Location of that loss
Tooth form, i.e. curvatures and embrasures
The positional relationship with adjacent teeth
The need for retention form
convenience
52

53. Box design
 Conventional design
 Margins are prepared to permit as great a bulk of wax
as is consistent with their subsequent finishing and
adaptation.
 This is a proximo-occlusal cavity , with its buccal and
lingual proximal walls finished so that the cavosurface
angle formed by the proximal flare and the tooth
surface will be at right or obtuse angles.
 Cervical bevel is usually placed with hand instruments ,
thus forming a lap joint with a bulk of wax suitable for
carving.
53

54. 54

55. 55

56. Slice preparation
 Referred to as extracoronal taper. It
is prepared using a disk of adequate
diameter to contact nearly the entire
proximal surface.
 It not only establishes a cervical finish
line but also eliminates much of the
proximal anatomical undercut.
 Presently, this only involves
conservative disking of the proximal
surface to establish the buccal and
lingual extent of the finish lines and
provide the lap joint for finishing.
56

57.  May extend to the cervical floor, or more frequently
will terminate at some point occlusal to the cervical
floor.
 Square form of teeth- will permit the use of a slice
that extends to the cervical floor.
 Ovoid or tapering – slice preparation terminates
short of the cervical floor.
57

58. Auxiliary slice
 This preparations wraps partially around the proximal line
angles, providing additional tooth support.
 Minimal bulk of tissue is lost , yet resistance form is greatly
enhanced, reducing the possibility of tooth fracture.
 An auxiliary slice around lingual proximal line angle will aid in
preventing a buccal displacement of the casting.
 Can conservatively include within the inlay preparation the
margins of a previous cavity.
58

59. 59

60. Modified flare preparation
 Hybrid between the box and slice
preparation.
 Buccal and lingual proximal walls
are initially formed with minimal
extension, then disked in a plane
that only slightly reduces the
proximal wall dimension.
60

61. Special modifications for the
preparation of the class 2 cavity
 Exceptions are the mandibular bicuspids.
Mandibular first bicuspid: central groove positioned
lingually to the midline.
Occlusal width- 2/3rds on the buccal side & 1/3rd from
the lingual side. And the pulpal floor to be slanted to the
lingual side.
Cervical floor will not be parallel to the pulpal floor.
61

62.  Mandibualr second bicuspid: 2/3rd and 1/3rd
relationship pertains especially to “u and y” shaped
occlusal patterns.
 May also necessitate a lingual extension to include
the lingual groove.
62

63. Capping cusps
 In case of extensive caries, when the occlusal
outline is extended up the cusp slopes more than
half the distance from any primary occlusal
groove to the cusp tip, capping the cusp should be
considered.
 Necessary to:
1. Protect the weak, underlying cuspal structure
from fracture caused by masticatory force.
2. Remove the occlusal margin from a region
subjected to heavy stress and wear.
63

64.  At this point in preparation of the pulpal floor, the
depth can be increased from 1.5mm to 2mm.
 Depth gauge grooves with 271 bur.
 Cusp reduction should provide for a uniform 1.5 mm of
metal thickness over the reduced cusp.
 Maxillary premolars and first molars, the reduction
should be minimal (0.75-1mm) on the facial cusp ridge
to decrease the display of metal & should increase
progressively to 1.5mm towards the centre of the
tooth to provide rigidity to the capping metal.
64

65.  A bevel of generous width is prepared on the facial
margin of a reduced cusp with a flame-shaped fine grit
diamond instrument , termed as reverse bevel or
counter bevel.
 Gives an angle that results in 30-degree metal.
65

66. Class III inlay design
 Greatest use in restoring lesions
on the distal surface of cuspid
teeth and will be frequently
performed by the direct method
of fabrication.
 Three basic outline forms:
Straight slot type with tapered
retention grooves.
Slot type with fluted grooves.
Step type of preparation with full
lingual interlock.
66

67.  Entry to any of the three designs is made from the
lingual side just inside the lingual marginal ridge of
enamel with the box penetrating towards the labial
surface .
 Has a lingual direction of draw.
 It is highly important to conserve the tissue
supporting the incisal edge.
67

68.  Straight slot type of cavity requires the removal of
the least amount of tissue.
 Major retentive factor is gained from
the tapered groove in the cervical wall.
 Depth of these grooves should
approximate ½ the diameter of the bur
being used.
68

69.  Initial preparartion with no.1 round carbide bur.
 169 tapered plain fissure bur.
 Cavity should receive a short cavosurface bevel on all of
its margins.
 Beveling of cavosurface margins:
incisal, labial and cervical- small gingival marginal trimmer
or flame shaped finishing diamond or bur.
Lingual margin- fine-grit carrot-shaped silicon carbide
stone.
69

70.  Slot Type With Fluted Grooves:
Grooves flare out of the cavity at the
incisal axial and the cervical axial
angles for distance of 1-2mm.
 Full lingual interlock step type:
Retention is supplemented in the
proximal box with tapered grooves in
the walls or in the cervical floor area.
A long bevel in the lingual incisal tooth
tissue provides a support.
70

71. Class IV inlay cavity design
 Two-surface cavity involving the proximal and the incisal
surfaces of an anterior tooth.
 Line of draw is incisally.
 No ½ or 1 carbide bur for initial entry through the area
of tissue loss.
 Definite labial, lingual and cervical floor should be
established.
 The incisal-cervical position of the incisal step is
determined by the labio-lingual width of the tooth.
71

72.  A retentive pinhole is placed in the incisal area to draw
with the proximal box using a 0.6mm twist drill.
 A continuous cavosurface bevel is placed around the
entite class4 preparation for the casting.
72

73. Class V inlay cavity design
 Outline form is generally- trapezoidal
smooth flowing form without sharp
angles at the junction of the mesial and
distal walls with the occlusal and
cervical.
 Axial wall in dentin should be curved to
conform to the pulp chamber.
 Prime consideration is the provision of
adequate retention.
 Pinholes should be placed in the axial
wall, usually at the junction of mesial
and distal walls.
73

74.  A no. ½ round bur is penetrated into the dentin
lateral to the pulp chamber to establish two shallow
dimples.
 0.6mm twist drill is used to drill parallel pin holes 1.5
mm deep.
 A no.2 drill is used to to bevel or countersink the
edges of the pinholes.
 A continuous cavosurface bevel is placed on the class
5 preparation.
74

75. Resin composite inlays
Composite inlay: defined as a restoration which is cemented into a
dental cavity as a solid mass that has been fabricated from
composite resin with a form established either by an indirect or
direct procedure.
75

76. Indications
 Moderate to large sized lesions, where sufficient
tooth tissue approximate for bonding and free of
marked undercuts remain following preparation.
 When there is no evidence of excessive tooth
wear in relation to patient’s age.
 Restoration not overloaded occlusally.
76

77. Classification of composite inlays
 According to the method of construction:
Direct technique
Indirect technique.
 According to the method of curing:
Superficial inlays: cured at elevated temperatures and
under pressure in one stage.
Heat cured rather than light cured.
e.g: SR Isosit system where inlays are cured at 120 c.
77

78.  Conventional cured inalys: light curing. EOS system.
 Secondary cured inalys: light curing at room
temperature followed by additional curing by heat and
light. E.g.coltene brilliant aesthetic line system in
which secondary curing is done under high light
intensity at 120 c for 7 minutes.
kulzer inlay system in which secondary curing is done
in an enclosed light activating unit.
78

79. Cavity preparation
 Preparation for inlays , as usual, requires creating a
withdrawal form.
Features are:
Remove existing restoration and /or caries.
Assess occlusion and identify abnormal occlusal contacts.
The restoration is assumed to be able to withstand occlusal
loading.
A taper of 8-10 degrees can be given on the opposing walls.
A minimum cavity depth of 1.5mm.
79

80.  Interproximal box width of ½ the buccolingual and an
occlusal isthmus width of 1/3rd the buccolingual width.
 Rounded internal line angles to reduce stress
concentration.
 Cavosurface bevels are not indicated
 If a cusp needs to be capped , a minimal reduction of 1.5
to 2mm is required.
80

81. Direct technique
 Restoration is fabricated and inserted during the same
appointment without the need for any laboratory
procedures.
 Technique:
 Prepared cavity is lined with tinfoil using a cotton
pledget and pressing the foil against the preparation
walls and line angles.
 A light cure resin restorative material is placed in the
cavity preparation over the tinfoil and polymerized.
 The inlay is then removed from the prepared cavity and
removed from the tinfoil.
81

82.  Proximal contact and contours are established,
after which the proximal surface is polished using
soflex disks.
 The teeth is cleaned with pumice, washed with
water, dried and enamel etching procedures are
carried out.
 A photoactivated unfilled resin is placed over the
etched enamel and dispersed with a gentle air
stream. And then cured.
 Inlay is tried into the cavity and if the adaptation
is acceptable, it is cemented with composite.
82

83. Indirect inlay technique
 The technique usually utilizes Isosit
composite material.
 It is a heat and pressure polymerized
BisGMA resin.
 The filler selected is aerosol, a form of
silicon dioxide that is 1000 times
smaller than the smallest quartz fillers.
 sponge like and absorbs fluids during
processing thereby bonding the
particles to the matrix.
 After the cavity preparation, rubber
base impressions are made and two dies
are made out of it.
83

84.  Die spacer applied on the cavity walls.
 Composite is applied in the cavity preparation and entire
cavity is filled.
 cured composite is relieved from the die.
 Additional curing is done in the oven.
 Composite inlay is etched and even the cavity.
 Primer is employed on composite inlay .
 Dual cure resin for cementation.
 Gentle finger pressure is applied and then cured.
 Polishing is done.
84

85. Advantages of indirect
technique
 Esthetically more pleasing.
 Improves resistance to breakage by bonding to the
etched walls.
 More durable, accurate, porosity free than
conventional methods.
 When cemented with a composite cement to acid
etched enamel, good marginal seal is achieved.
 Restoration is repaired in the mouth.
85

86. Ceramic inlays
 Internal form External form
• 1.5 to 2 mm of pulpal depth 90 degree cavosurface margins
Rounded internal line angles 2 mm of isthmus width
• 10 to 12 degrees of axial 2 mm of occlusal reduction
wall convergence for cuspal coverage
• Greater than or equal to Smooth flowing margins
10 degrees of divergence
on buccal and lingual walls
• 1 to 1.5 mm of axial wall reduction
86

87. Use of ceramic inlays
Indications include most of the typical indications for cast-
metal inlays, with the added requirement for a tooth-
colored restoration.
Ceramic inlays can be conservative of tooth structure, and
permit preservation of much coronal tissue.
They can be used in lieu of a metal-casting or amalgam
restoration in patients who require a class II restoration
where buccal and lingual walls remain intact, and offer a
viable alternative where excessive isthmus width may
preclude the use of a direct posterior composite
restoration.
87

88.  Ceramic inlays are stronger than direct posterior
composite resins, offering superior physical
properties than the latter, as the limited degree of
polymerization conversion of direct posterior
composites limits their strength.
 However, the advantage of the ceramic inlay over the
composite resin may be limited by the possible need
for an additional appointment, the greater skill level
required to deliver the treatment, and the higher cost
associated with the materials used.
Considerations for ceramic inlays in posterior teeth: a review
Clinical, Cosmetic and Investigational Dentistry 2013:5;21–32
88

89. conclusion
 Inlays are employed in clinical situations which are
beyond the scope of amalgam restorations.
The technique requires multiple patient visits
and excellent laboratory support, but the resulting
restorations are durable and long lasting. In order to
maximize their advantages and minimize their
disadvantages, the cavity preparation for inlays is very
specific.
89

90. References
 Operative dentistry. Modern theory and practice.
M.A.Marzouk.
 Sturdevent’s Art and science of operative dentistry.
Fifth edition.
 Principles and practice of operative dentistry. Gerald
T.Charbeneau. Third edition.
 Textbook of operative dentistry: second edition.
Vimal.k.sikri.
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91.  Operative dentistry: Gilmore, Bales, Vernetti, Lund.
Fourth edition.
 Fundamentals of operative dentistry. A contemporary
approach. James B.Summit. Third edition.
 Considerations for ceramic inlays in posterior teeth: a
review.Clinical, Cosmetic and Investigational Dentistry
2013:5;21–32
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