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Ceramic Inlays

Ceramic Inlays

Ceramic inlays are the best way to restore posterior teeth. The round contact point in between the teeth can be prepared by the dental technician in the best way, as compared to a direct, ordinary class II filling restorations. Also, patients who present allergy to metals and who desire a highly esthetic restoration might benefit from ceramic inlays because these restorations are extremely biocompatible (ceramics are among the most compatible biomaterials) and can mimic the appearance of the natural tooth, when properly made.

Ceramic inlays are tooth-colored glass-based restorations used as fillings in back teeth (molars and premolars). These fillings are made of dental porcelain in a dental laboratory using a copy or model of the tooth preparation obtained from a mold made by the dentist. After being completed, the inlay is cemented in the tooth preparation with composite cement.

The X-Ray shows interproximal caries in between the lower right molars and inaccurate edge -to-edge termination of the class II fillings in between the molar and the premolar.
The preparation of the teeth needs to be totally extrusive, so that the ceramic inlays can be set in place easily. The retention is obtained by means of the cement composite and the adhesives. In order to obtain a good silicone impression, the papilla can be cauterized with an electro scalpel. The papilla will grow back again after the ceramic inlays are definitely set in place. The displacement of the papilla can also be achieved by using retraction threads.
The provisories for the ceramic inlays are made with a soft, light cured composite. These are the views at the moment of setting and one week after. The provisories should be easy to remove with a probe, for example, and they hold themselves in place without cement.
This are the views of the preparation in cast, and the set-up display in mouth prior to cementation. A rubber dam is used for isolation of the desired teeth, with the help of one or two clamps. Correct rubber dam isolation and correct use of adhesives are both vital for a long lasting result.
This is the final mimetic result of the ceramic and a check X-ray in order to control the contact points where the eye doesn’t reach. A small excess composite still needs to be removed from the contact point in between the molar and the premolar.
Dental technician:
Thomas Hirsch, Zahntechnikermeister, Langobardenstrasse 35/1a, 1220 Wien, Österreich

Combined case. Restorations, Orthodontics, Implants & Veneers. Five & ten year results.


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This a long, multidisciplinary case, involving peridontics, endodontics, resin restorations, orthodontics, implants and venners.You can view the full process here…

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Restorative phase
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Orthodontics
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Orthodontics & Implants on 12, 35
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Removal of orthodontics, bleaching & retainer
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Prosthetic Phase & retainer
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results: 5yrs post implantary phase, 10yrs from restoration
alexis sanchez
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Composite restorations in posterior teeth, interdental zone

Composite restorations in posterior teeth, interdental zone

El caso muestra unas restauraciones de resina con un acabado de bordes irregulares, que esta provocando problemas en la encía y filtración de caries bajo los mismos.

This case shows two composite resin restorations with irregular terminations that are provoking periodontal disease and decay filtration under the fillings. IMGP7842IMGP7843

Se retiran los dos empastes existentes y se aísla la cavidad, con una matriz de metal y una cuña de madera, para crear un “encofrado”, donde la resina del empaste puede introducirse sin que se salga, ni que haya filtración de sangre o saliva, y proporcione la forma contorneada de un diente natural.
Both fillings are removed and the cavity is isolated, with a metal band matrix and a wooden wedge, in order to create a mold where the resin can be laid in without leaking out or letting in blood or saliva. The mold provides the rounded contour of a natural tooth.
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Se rellena de composite, primero un diente, y después el otro, siempre en pequeños incrementos, para evitar una contracción grande durante el curado de la resina, que se hace con luz (fotopolimerización).
Composite is packed inside, one tooth at a time, always in small increments, to prevent contraction during light curing (fotopolimerization)IMGP7846 IMGP7847IMGP7848

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Para terminar, se pulen las aristas y se comprueba el sellado y la mordida.
To end with, edges are rounded and polished. Restoration seal and bite performance are checked.

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interdental restoration in incisor

interdental restoration in incisor

Se detecta una caries asintomática entre los dos incisivos centrales durante una revisión periódica. En la vista de frente apenas se distingue un cambio de coloración

An asymptomatic decay is detected in between the two central incisors during a routine check. In the front view one can hardly distinguish but a slight color change.

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Pero en la exploración de la parte posterior del diente el cambio de color revela una caries bastante grande

But the rear side shows a big decay under the dark colored spot.

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se prepara una cavidad en el esmalte para tener acceso a la dentina (parte intermedia del diente, entre el nervio o pulpa y el esmalte exterior). Estas caries casi siempre afectan a las superficies de los dientes contiguos. Una suele ser mayor que la otra.

The cavity is drilled on the enamel in order to expose the dentine (intermediate layer in between the external enamel and the inner pulp). This cavity normally affects to both side by side teeth, but one is usually larger than the other.

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se limpia la caries en la dentina y se da forma a la cavidad

Decay is removed from dentine and the final shape of the preparation is carved.

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a continuación se coloca el composite de restauración, con pequeños incrementos y mezclas de colores para lograr una mimetización del color

Then, I place the composite filling, in small amounts and mixtures of colors, in order to get maximum color camouflage.IMGP4988

vista después de la obturación, con un excelente resultado estético. Nadie podría adivinar lo que hay detrás.

Result after finishing, with an excellent esthetic result. No one can tell what’s behind…

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Esthetic reconstruction with composite in incisors

Esthetic reconstruction with composite in incisors

Este caso muestra la reparación de la fractura de un incisivo central y una caries en el cuello del diente.

This case shows a fractured reconstruction on the incisal edge of a front tooth and a cavity on the gingival border of the same tooth.IMGP7702

Elimino la caries y los restos de los empastes anteriores.
I clean the decay and remove the old fillings IMGP7703
A continuación se aíslan las superficies, se aplica un ácido, una resina adhesiva y el composite, de distintos colores y por capas, para conseguir el resultado estético adecuado, mimetizándose con el color del propio diente y los de al lado.
Then, I apply an acid, a bonding resin and the composite material, with different colors and layers, to provide a convenient esthetic result, matching the color of the tooth.

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