Inlay restoration using CAD/CAM

Digital - Shadeguides - Cases - Indirect posteriors
2017-05-24

The purpose of this article is to underline the advantages of indirect posterior restorations and to remind the usage of CAD/CAM Connect System requires a minimum investment. Large, direct composite restorations take a long time, because of many reasons; posterior teeth are difficult to reach and we have to use different devices such as matrices, wedges, rings… this with an incremental technique, in order to minimize polymerization shrinkage; sometimes it is difficult to make proper occlusal adjustements, and to get well polished contact points. The procedure is tiring, both for the patient and dentist. We can complete the same procedure easily with a CAD/CAM system on the same day by using ceramic or hybrid blocks.

Fig. 1

Img. 1 – Patient presented with a large double surfaced amalgam restoration on tooth number 16, complaining about mild sensitivity.

Fig. 2

Img. 2 – X-ray of the initial position.

Fig. 3

Img. 3 – After proper isolation of the field, the amalgam restoration was removed; a deep dentin decay was detected under the mesial wall. After cleaning the decay, an MO cavity preparation was done according to the indirect technique.

Fig. 4

Img. 4 – A digital impression was taken and all data was sent to the Connect System laboratory after having covered the whole dentin surface with a self-etching adhesive system and a thin layer of flowable composite.

Fig. 5

Img. 5 – Onlay designed by the Connect System laboratory.

Fig. 6

Img. 6 – Design in occlusion.

Fig. 7

Img. 7 – Polished hybrid onlay.

Fig. 8

Img. 8 – We can easily add some occlusal characterizations if necessary, by using composite stains.

Fig. 9

Img. 9 – Before cementation we can use a sticky tipped placement tool in order to handle the onlay easily.

Fig. 10

Img. 10 – Occlusal check just after cementation. Note the small palatal cavity was restored directly by using injectable composite.

Fig. 11

Img. 11 – We can easily polish the trimmed parts of the hybrid onlay by using a two step diamond impregnated rubber wheel set.

Fig. 12

Img. 12 – Onlay in occlusion.

Fig. 13

Img. 13 – X-ray after cementation.

 

The indirect technique offers a more comfortable procedure both for the patient and the doctor. By using a CAD/CAM system on large single posterior restorations we can minimize chair time, avoid using multiple materials, reduce polymerization shrinkage complications, construct proper contacts and establish a good occlusal relation.
CAD/CAM Connect System enables us to use this procedure without investing a lot of capital. You can contact a local dealer for further information.