Inlays & Onlays

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A crown replaces the entire external part of a tooth. An implants replaces the entire tooth, with a metal post substituting for tooth’s interior and root. But it is also possible to just replace part of the tooth. This is a good option if only part of the tooth is worn, misshaped or damaged.
Inlays and onlays are used to replace sections of the molars or premolars. The chewing surfaces of these molar teeth is always indented, because this aids chewing. Often this indented area is hard to clean and prone to decay. Else, is may simply be unsuitably rough. So this section of the molar/premolar can be replaces with inlay or onlays.
Inlays replace the top centre part of the molars. Onlays replace both this top centre of the tooth and one or more of the outer raised cusps. If the entire top of the molar is replaced the replacements section is called an overlay.

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For many generations the inlays and onlays were made of gold. They were essentially a gold filling. More recent generations had inlays and onlays made from porcelain, which looked fairly natural. Today these inlays and onlays are made from ceramic materials, which are predesigned to suit the individuals tooth.
Modern inlays and onlays are superior to fillings because they help strengthen the structure of the tooth. A filling will only work if the tooth already has fairly good structural integrity. With molars and premolars this structural integrity is important because chewing puts considerable pressure on the back teeth.

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Inlays and onlays benefit form computer aided design (CAD) and computer manufacture (CAM). A mould of the individual’s mouth or computer 3D model is used to design and create the right shape inlay/onlay, which is then fitted into place by the dentist. The exacting standards of computer modelling and designing means the piece or replacement tooth will be a very exact fit. This greatly reduces any problems with gaps between the natural tooth and the replacement section. Any gaps would leave the tooth open to decay.

Inlays & Onlays

Dental Veneers are a little like a crown, but they only cover the front of the tooth. This is very useful for some people who have minor or moderate problems with their teeth. They can certainly improve the appearance of poorly coloured or slightly misformed teeth.

Veneers are of two basic types. The older type consisted of a resin that was applied to the teeth, which then hardened in place. Or they can be porcelain surfaces, custom designed for the individual’s mouth. This porcelain type of veneer has proved more successful.

Veneers can

• Hide imperfections on the individual tooth, like chips, or an uneven surface.
• Hide a poorly coloured tooth with a neatly coloured veneer
• Effectively fix a misshappen tooth.
• Fix some alignment problems with teeth.
• Neatly fix teeth that are too widely spaced
• Fix minor overbite by effectively moving the teeth slightly forward.

Modern veneers are durable, effective for many cosmetic dental problems, and require only a few dental visits. 

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Custom made implants, crowns and veneers can improve the function and appearance of damaged or poorly formed teeth. Modern materials make these dental devices stronger and more natural looking than ever before.

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Few of us ever manage to naturally achieve neat teeth. Many of us require braces or other orthodontic treatment to straighten crooked or misaligned teeth. Others require crowns or even dental implants for their mouth to look right and function well. Occasionally patients need both orthodontic treatment and further alterations to their teeth. But certain combinations of treatment are not possible, or certain combinations of treatment must be done in the correct order.

Braces are almost always possible on natural teeth, but may not be possible if the natural teeth have been replaced.

Braces and crowns

Crowns are used to replace the outer part of a damaged tooth, or the outer part of a tooth that is considered unattractive. These crowns are made in a dental laboratory, specifically designed to suit the individual’s mouth.

It is possible to put braces on crowned teeth. A different adhesive is used to attach the braces to the crown, in order to prevent damage to the surface. Otherwise treatment is the same.

It is the root of the tooth that is moved by braces. As the natural root of the tooth is still present in a crowned tooth so it is still possible to use braces to alight the teeth.

If the tooth alignment problems are not too severe it might be best to consider Invisalign (clear aligners) for the orthodontic work.

Root canals and braces

Braces can be used on teeth that have had root canal treatment. Root canal treatments can be performed when braces are still being worn. There should be no problem in either case.

Implants and orthodontic treatment.

Implants and orthodontic treatments do not really mix.

Dental implants will completely replace the natural tooth with a metal post and a realistic looking facsimile tooth. The metal post, which is bonded to the jawbone, cannot be moved with braces or any other orthodontic treatment. This means braces are generally not used when a patient has implants.

Occasionally braces or Invisalign might be used if teeth other than the implant need to be moved. Natural teeth can be moved relative to the implanted teeth. And of course if the implant is on one jaw the braces can still be used on the other jaw.

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Dental labs can replace teeth or heavily modify teeth with crowns and implants that look very natural and which are custom designed do suit each individual mouth.

It is best to have the braces used before any implants or crowns are used. Implants cannot be moved once that are attached, though it is still possible to move teeth that have been crowned.

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For the past generation or two most implants were a combination of a metal post and a ceramic tooth. Previously this meant a titanium post and a porcelain replica tooth. For the past few years the porcelain replica has been replaced by lithium disilicate for the front teeth (stronger than porcelain and natural looking) or ziriconia for the back molars (even stronger, but not looking as realistic). The technology has moved again, with the metal post now becoming obsolete. Implants can now be made entirely from ceramic material.

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All ceramic implants have a few advantages.

• They can be made completely translucent, with no fear of a metal post becoming visible.
• They can be made thinner so as to fit into a smaller space. This is an advantage for some people who do not have enough room in their mouth to accommodate a larger implant.
• The ceramic material is biocompatible, so the natural gum can grow back alongside the tooth.
• There is virtually no issue with the tooth being sensitive to hot and cold temperatures.
• There is no risk of allergic reaction. This would occasionally occur with some patients who were allergic to nickel (in stainless steel) or other metals.

One of the main advantages of titanium implants was osseointegration. This meant that the titanium post would biologically fuse to the jawbone, making for a very strong bond. A similar process has been obtained with ziriconia implants; ziriconia implants with a roughened surfaces will also fuse to the jawbone, so the advantage obtained with titanium is also achieved with the new all ceramic (ziriconia) implants.

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Tried and true technology that has proved reliable will often continue to be used even when new options are available. Many people continued to use gold crowns long after porcelain became available. But the new technology will find its market and become mainstream over time. People with metal allergies will have to use all ceramic implants because they have no other option. And if these all ceramic implants prove to be a good long term options then they will come to replace many older types of implant.

Mouthguards

A mouthguard will not prevent an accident, but is can greatly reduce the damage sustained to the teeth. A mouthguard can be the difference between a lost tooth and a bad bruise.

Generic mouthguards are cheap and easy to obtain. And they work reasonably well. But these generic variety will often be uncomfortable. The best option is a custom mouthguard.

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A custom made mouthguard will be modelled on the individual’s teeth. A 3D impression is made of the teeth using a soft mould filled with Hydrocolloid gel. A mouthguard can be designed to neatly and comfortably fit the model of the teeth.

Computer aided design and manufacture allows high quality mouthguards to be made in minimal time.

There is a range of different Custom Mouthguards for different type of sport.

Single laminate mouthguards – ideal for low impact sports like soccer or basketball. These are best for young children.

Double laminate – is for medium impact sports like football or hockey.

Professional range – some sports require maximum protection, like martial arts or boxing.

There are also mouthguards used for correct breathing at night.

A mouthguard is more essential than the sport uniform. If offers significant protection for the teeth. Custom mouthguards are the best option of all.