restorative dentistry
normal fillings
Prosthodontists do normal fillings as part of an overall treatment plan. These days they are usually made from composite resin, a very aesthetic tooth coloured material that is placed directly in the tooth in a single appointment. These fillings are bonded into the tooth and, to ensure a long lasting bond, dam is always used. Composite resin restorations are very "operator sensitive" and usually take a lot longer to place than their silver amalgam counterparts.
Where teeth have been badly worn down and something is needed to build them up to their previous height, direct fillings can be used. Even with excellent operator skill the final contours of these very large restorations is never as good as those made in a laboratory. However this form of treatment can be an excellent medium term solution that is very cost effective.
The case below illustrates a whole lower arch of direct fillings building up the teeth (there is a crown at the lower left first molar)
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inlays
Ceramic or composite resin inlay/onlays can be made in a laboratory and are used in situations where the cavity is either too large for a direct filling or where ideal contour and aesthetics are required . They are usually chosen because they involve different tooth reduction compared to crowns. At the first appointment a cavity is prepared, an impression taken, and some form of provisional restoration placed. A few weeks later, the provisional restoration is removed and the inlay/onlay is bonded into the tooth. They are called inlays when they fill a cavity and onlays when they extend outside the cavity to cover over the top of part or all of the prepared tooth. Often they are a combination of the two.