An inlay is a form of dental prosthesis manufactured in a dental laboratory that can be permanently inserted into the tooth. In most cases, extensive carious defects are treated with an inlay.
However, it is also possible to use an inlay to treat tooth defects that have arisen in the course of trauma. In contrast to classic, plastic filling materials (plastic), which are introduced into the tooth in liquid form and then hardened, an inlay is precisely shaped and then glued into the tooth to be treated.
For this reason, inlays are usually much more resilient and on average have a longer shelf life than normal tooth fillings. In dentistry a general distinction is made between:
- Plastic and
- Titanium inlays
In addition, in some cases, inlays are made from gold-ceramic mixtures.
Read about it too: The inlay as a restoration for a destroyed tooth
What is a ceramic inlay?
As the name suggests, a ceramic inlay consists of particularly stable, break-proof ceramic. In the dental laboratory, a ceramic inlay can be produced in various ways, depending primarily on shape and size. In contrast to the somewhat more stable gold inlay, a ceramic inlay has the advantage that, when optimally adapted, it cannot be distinguished from the normal tooth substance by the layperson and is therefore inconspicuous.
In addition, a ceramic inlay is particularly suitable for patients who have little natural tooth substance left after removing a carious defect. Due to the close connection between the dentin (lat. Dentine) and ceramics, the tooth structure can be strengthened and the tooth can be made more resilient.
Procedure and production of the ceramic inlay
In the case of small carious defects, the removal of which still leaves sufficient tooth substance, it is usually sufficient to fill with amalgam or plastic-containing materials. In the case of extensive caries and large tooth substance losses, in addition to the actual filling of the hole, care must also be taken to ensure that stability is maintained during the chewing process.
In the case of ordinary fillings, there is generally a loss of stability, which means that the affected tooth can only insufficiently withstand the forces acting on it during chewing. For this reason, after removing a large caries, a ceramic inlay should be made to be thought about.
1. Preparation of the tooth for a ceramic inlay
Before the ceramic inlay can be manufactured in the dental laboratory, some preliminary work must be done. On the one hand, the dentist treating you must Completely remove the carious defect and ensure that all germs completely out of the cavity (Tooth cavity) to be eliminated. This treatment step takes, depending on the extent of the carious defect, a period of time about an hour in claim.
Then the cavity prepared to accommodate the ceramic inlay become. Only if all indentations of the affected tooth sanded clean the ceramic inlay optimal hold Find.
After successful preparation of the tooth, a Impression made of the dentition become. Just with the help of one as precise an impression as possible can the dental technician precisely fitting ceramic inlay produce.
Following the preparation of the tooth to be restored, the the patient's exact tooth color is determined become. This step in particular is essential for the production of a ceramic inlay, which later sits inconspicuously in the oral cavity.
Since the production of the inlay in the dental laboratory takes a few days, the the prepared tooth is temporarily restored become. For this purpose, the attending dentist provides one in the practice temporary filling made of plastic here.
2. Insertion of the ceramic inlay
After the ceramic inlay has been made in the dental laboratory, it can be used in a second treatment session glued into the tooth become.
To the tooth in front Saliva and bacterial pathogens to protect, he will use a Elastic bands (so-called "coffer dam") completely completed.
This is followed by the Removal of the temporary filling material and the Preparation of the tooth cavity. To one optimal hold To ensure and to improve the connection between the tooth surface and the ceramic inlay, the cavity must be chemical acid roughened become.
To avoid an overly sensitive reaction of the tooth To avoid heat stimuli, he will then with a special material sealed. The actual insertion of the ceramic inlay usually only takes time a few minutes. After this Application of the adhesive material the inlay is inserted into the cavity and whose seat as of Ultrasonic controlled. Then the Glue through the Application of UV light activated and hardened become.
A optimally adapted ceramic inlay is after insertion no longer distinguishable from the natural tooth surface.
Follow-up care for the ceramic inlay
A ceramic inlay can be fully loaded relatively quickly after it has been inserted. However, in the first few hours after gluing in the inlay, the patient should pay attention to a few basic things:
1. Eating: Immediately after the visit to the dentist, nothing should be eaten for about three to four hours, as the adhesive used has to dry out completely during this period. This is the only way to guarantee an exact fit and an optimal marginal fit.
If too much pressure is exerted on the ceramic inlay during this period, this can have a negative impact on the interaction between the inlay and the natural tooth substance. In this case, premature loss or displacement of the ceramic inlay within the cavity can occur.
In addition, there is a risk that food residues will get stuck in the not yet fully cured adhesive and subsequently serve as a breeding ground for bacterial pathogens. The consequence can then be the formation of new carious defects under the ceramic inlay.
2. Oral hygiene: In addition, after dental restoration with a ceramic inlay, particular attention must be paid to thorough and regular oral hygiene. In addition to normal tooth cleaning with a toothbrush, the spaces between the teeth should also be cleaned at least once a day. Dental floss or interdental brushes are particularly suitable for this purpose (Interdental brushes).
Pain in a ceramic inlay - what could be behind it?
A ceramic inlay is made in the dental laboratory after the dentist has ground the tooth into shape and removed caries and diseased tissue. If bacteria remain in the tooth, it is possible that there is caries under an inlay, which is causing the pain. The caries can either still remain or be new.
Since the ceramic inlay is very hard and the tooth under the inlay has become more porous due to caries, the hard ceramic presses on the soft, unprotected tooth. This manifests itself as a toothache.
A ceramic inlay can be painful even with a healthy tooth. For example, if the contact with the neighboring teeth is too strong, the teeth will be pushed apart, as the ceramic is more stable and stronger than your own tooth.
This fact is also a problem with people who attend Bruxism (Grinding, pressing) suffer. If you press your teeth together, the “ceramic tooth” is stronger than the healthy tooth in the opposite jaw. The pressure that the healthy tooth has to withstand leads to pain. Although this pain originates in the opposite jaw, it can also radiate into other teeth, so that the pain cannot be precisely localized.
Immediately after grinding the tooth for the ceramic inlay, the tooth can hurt. The treatment with the grinding tools and the cold water irritates the tooth. If the inlay is inserted, the tooth must be treated with acid and other materials, which can also cause the tooth to hurt for a few days. If the symptoms persist for more than 14 days or if they get worse, a visit to the attending dentist is necessary.
It is important that the inlay feels good when inserted. If you have the feeling that the inlay is “too high”, the dentist has to grind in the imperfections. Otherwise it can not only cause pain in the tooth or opposing tooth, but also in the jaw joint.
What is the difference between a crown and a ceramic inlay?
The difference between an inlay and a crown is clear.
With a crown, the tooth is not only shortened in height, but also ground all around. With the inlay, the cusps are usually not ground; see the example image of a ceramic inlay above. The transitions between an inlay, onlay (is placed) and overlay (also includes a tooth cusp) are so fluid that, for the sake of simplicity, people speak of an inlay.
Depending on how big the defect is, you have to consider whether a ceramic inlay is still possible. In the case of larger defects, the tooth must first be repaired with a fill-up and provided with a crown.
If the defect is smaller, an inlay can also be used. However, the remaining tooth walls must have a certain thickness, otherwise the walls will collapse after the stable ceramic has been inserted. If the defect is only on the chewing surface and possibly also in the space between the teeth, then a ceramic inlay makes sense. However, if several surfaces and cusps are affected, a crown is the better choice, as it offers the tooth greater stability.
The price of a ceramic inlay is roughly the same as that of a crown. Although the material costs themselves may be lower, it is more time consuming for the dentist and technician to manufacture. In addition, the ceramic inlay (just like a plastic filling) is a private service. A crown is at least partially subsidized by the statutory health insurance.
Read more about this at: Crown
What are the costs of a ceramic inlay?
Since the costs for a ceramic inlay are made up of various individual values, it is not possible to specify a flat-rate price. The production of a ceramic inlay is, however, a so-called private service, which means that statutory health insurance companies are not obliged to cover the costs.
As a rule, however, at least part of the amount is covered by the insurance; all other amounts must be paid by the patient himself. The cost of a ceramic inlay is roughly composed of four areas. In addition to the individual wishes of the patient and the material costs, the prices of the treating dentist and the dental laboratory also play a major role.
In addition, the price of a ceramic inlay is different from that
- Material quality and
- exact fit
Depending on the dental practice, the patient can expect a price between 300 and 700 € for the production of a simple inlay. In view of the fact that the ceramic inlay can usually remain in the oral cavity for a long period of time due to its high accuracy of fit and high quality, such a price is justified
Durability of a ceramic inlay
The dentist has a 2 year guarantee. With good care, the inlay lasts much longer on average. The shelf life depends on many factors.
- On the one hand, there are different ceramics with different ingredients and therefore different properties. Harder ceramic is more stable, is not sanded down, but can break more easily if, for example, the inlay is under tension between the neighboring teeth.
- A softer ceramic inlay may break less quickly, but may need to be replaced sooner because it is worn out.
- As soon as the ceramic has cracked or cracked, it must be repaired. This is usually easier with veneer crowns.
- With an all-ceramic inlay, it makes more sense to manufacture a new one that exactly matches the defect on the tooth. A ceramic inlay is a demanding job for both the dentist and the technician. When gluing in, all work steps must be carried out precisely, otherwise the “glue” will come off prematurely. The technician must design the inlay exactly to match the defect in order to avoid possible tension.
- The better the inlay is cared for, the longer it will last. Dental care with ceramic restorations is very important because the glue at the transition between ceramic and tooth washes out over time and forms an entry point for caries bacteria. As soon as the tooth is carious, the inlay must also be removed and replaced.
- If all factors are correct, a ceramic inlay can not only last 10-15 years but also to the end of life.
Ceramic inlay vs gold inlay - which is the better material?
- The most noticeable difference between a ceramic and gold inlay is the color. The ceramic is tooth-colored, gold catches the eye even of a layperson.
- The advantage of ceramics is that an inlay can be designed in any possible brightness. With different colored ceramics or by painting it is possible to make the inlay look as real as possible. The inlay is practically invisible. Aesthetically, the ceramic outweighs the gold inlay.
- In contrast, gold also has some advantages over ceramic. Like all metals, gold is created in such a way that no bacteria can accumulate. This means that bacteria do not like to settle on the inlay. In the case of poor oral hygiene or elderly people, a gold inlay is a good choice, as the gold sometimes forgives small toothbrushing errors.
However, it is also not advisable to young people or people with good oral hygiene to opt for a gold inlay, as significantly less healthy tooth structure has to be removed than with ceramics.
- Ceramic like glass or porcelain must have a certain thickness of 1-1.5 mm, otherwise it will break. With gold, a layer thickness of 0.3 mm and less is sufficient. If the defect is relatively small, it would be unfavorable to remove healthy tooth substance just to be able to insert a ceramic inlay.
- There is not much difference in price at the moment. The price of a gold inlay varies depending on the gold price. The ceramic is a little cheaper, but since you have to replace less tooth substance with a gold inlay, you also need less grams of gold.
Learn more about that here Gold inlay