What is the difference between a filling, an onlay and a crown? The goal of any restorative procedure should be to remove as little tooth structure as possible to achieve a sound result. A filling is a good choice when there is about half or more of sound tooth structure remaining to lend structural support. When more than half of the tooth structure is missing or there are cracks present in the tooth then there is a need to cover the remaining surfaces of the tooth to protect it from further fracture with either an onlay or a crown. How much tooth needs to be covered depends on the extent of the cracks, decay, etc. With proper tooth preparation, material selection and technique, a porcelain restoration can blend seamlessly into natural tooth structure while keeping it conservative.
Recently, one of our patients presented with pain upon chewing due to some cracks that developed around his tooth. A porcelain onlay was treatment planned for him.
Note how the tooth preparation is kept well above the gum line and made to only cover the top of the tooth.
Proper cleaning and preparation of porcelain restoration.
A high strength, esthetic porcelain onlay material was selected and bonded into place with a mix of colored cements to make the line between porcelain restoration and tooth structure undetectable. Coverage of all cracks eliminated the pain upon chewing while delivering a beautiful result.