The vestibular inlay crown
summary:
- Introduction
- Definition
- Benefits
- Disadvantages
- Indications
- Contraindications
- Preparation of the stumps
- Conclusion
- Bibliographic references
- Introduction : [1-3]
The demands of some patients have led practitioners to seek ways to improve the appearance of metal caps, giving them a more natural appearance and more in harmony with the rest of the teeth.
The ideal for the visible region of the dental arches is that they are perceived unharmed and healthy. Its extent varies according to the patient, for the most part, all the anterior teeth, the maxillary premolars and first molars and the mandibular first premolars are part of it.
- Definition of the vestibular inlay crown : [1]
There are three types of crown covering: metal crown, ceramic crown and metal-ceramic crown, the latter includes the inlay crown which is defined as follows:
It is a full-coverage crown, made of cast metal, with a cosmetic element on its vestibular face: acrylic resin or ceramic.
The vestibular inlay crown
- Advantages of the vestibular inlay crown : [1]
- It has the strength of a metal-covered crown.
- It allows the restoration of aesthetics.
- Disadvantages of the resin vestibular inlay crown : [1]
- Lack of adhesion of the cosmetic material, hence the risk of unsealing.
- Discoloration of the resin by infiltration.
- Wear of the resin under the influence of brushing and the hook of an attached partial prosthesis.
- Indications for a vestibular inlay crown : [1-3-4]
- Indicated for the visible region of the arch.
- Indicated for single or multiple restoration as bridge anchorage.
- Indicated on pulped or pulpless decayed teeth.
- Indicated for misaligned teeth.
- Indicated when the occlusion is tight.
- Contraindications for a vestibular inlay crown:
- Badly damaged tooth.
- Significant tooth mobility.
- Untreated apical lesion.
- Anchoring preparation : [1-2-3]
Vestibular face :
The preparation is characterized by a significant reduction of the vestibular face which is 1 to 1.2mm for the resin CIV and it is 1.2mm to 1.4mm for the ceramic CIV, to allow the installation of the metal infrastructure and the cosmetic layer.
This reduction is done on two planes: cervical and occlusal to avoid any pulp lesion and to have an equal thickness of the prosthetic material over the entire face.
To respect the two planes, vestibulo-cervical orientation grooves and other vestibulo-incisors are made with a flat-ended cylindrical-conical diamond bur, the remaining dental substance between the grooves is eliminated. The reduction of the vestibular face extends from one proximal angle to the other, 1 mm lingual from the contact points.
The cervical limit is cut at the same time as the reduction of this face with a width of 1.2mm it is a shoulder, the level of the cervical limit is subgingival from 0.5mm to 0.6mm.
The vestibular inlay crown
Proximal face:
Access to the proximal faces is obtained with a long, thin, conical diamond bur to reduce the risk of notches on adjacent proximal faces.
The clearance of the proximal faces is first obtained with the flat-ended conical diamond bur. Then the diamond fillet bur traces the cervical limit of the proximal faces.
These two mesial and distal flats thus obtained create the union of the proximal faces with the vestibular and lingual faces.
Palatal face:
First the cingulate part, the cervical third must have the shape of a cylindrical ring using a cylindrical bur with a rounded tip, held parallel to the cervical part and at the same time we make the cervical limit which is a fillet, this fillet extends on the proximal face until it meets the shoulder.
The palatal concavity is then reduced using a wheel bur or large ball bur to provide sufficient space for the thickness of the metal; the thickness to be reduced depends on the occlusal relationships with the opposing teeth.
The vestibular inlay crown
Free edge:
At the end of the cut, the free edge must be flat and inclined in the palatal direction for the upper teeth and in the vestibular direction for the lower teeth.
All corners and edges must be rounded.
- Conclusion: [1]
The idea of applying the aesthetic means of inlay to our prosthetic art is not new, it dates back to the most ancient times, their design has been modified according to the resins increasingly better adapted to the oral environment. It seemed to us that the return of quality porcelain veneers and pontics as well as the arrival of new metal-ceramic materials, stopped the use of acrylic resins in fixed prosthesis, however the cost price of porcelain inlay caps makes their daily use prohibitive.
The vestibular inlay crown
- Bibliographic references :
- L ROUCOULES modern techniques for the construction of intra and extra coronary elements. 3rd edition 1972
- HERBERT SHILLINBURG: FUNDAMENTAL BASE IN FIXED PROSTHESIS 3RD EDITION 1997
- SHILLINGBURG/JACOBI/BRACKETT FIXED PROSTHESIS PREPARATION PRINCIPLES AND CLINICAL APPLICATION: SHILLINGBURG/JACOBI/BRACKETT CDP edition
- FRONCOIS UNGER, PHILIPE LE MAITRE, ALAIN HOORNAEART FIXED PROSTHESIS AND PERIODONT edition CDP
The vestibular inlay crown
Wisdom teeth can be painful if they are misplaced.
Composite fillings are aesthetic and durable.
Bleeding gums can be a sign of gingivitis.
Orthodontic treatments correct misaligned teeth.
Dental implants provide a permanent solution for missing teeth.
Scaling removes tartar and prevents gum disease.
Good dental hygiene starts with brushing twice a day.