indirect Inlays, Onlays and direct composite restorations

When more than half of the tooth’s biting surface is missing, damaged or has an old deteriorating restoration, we will recommend the use of inlays, onlays or on rare occasions, full crowns.

What are inlays and onlays?

Inlays and onlays are considered the ideal treatment restoration when durable aesthetic indirect posterior restorations are required in a tooth that still has a moderate to considerable amount of healthy tooth structure remaining. They can also be used to restore an otherwise healthy tooth which has a large silver filling that is unattractive aesthetically.

Inlays and onlays can be made of porcelain, composite resin or gold. The porcelain and composite resin restorations are directly bonded to the damaged area of the tooth and have a mechanical as well as chemical bond which seals the tooth completely and protects against recurrent decay while a gold inlay is cemented but not bonded to the tooth surface and though it is very strong and durable, suffers from the lack of aesthetic appeal due to its gold or silver-gold color.

Traditionally, gold has been the material of choice for inlays and onlays before the development of the space-age materials and bonding agents we use today. In recent years, however, porcelain and composite restorations have become increasingly popular due to their strength and color with porcelain being the stronger and more durable of the pair but both can potentially match the natural color of your teeth.

How are inlays and onlays applied?

Inlays and onlays require two appointments to complete the procedure. During the first visit, the silver or composite filling being replaced or the damaged or decaying area of the tooth is removed and the tooth is prepared for the inlay or onlay. To ensure proper fit and bite, an impression of the tooth is taken and sent to a lab for fabrication. We will then apply a temporary filling on the tooth and schedule the following appointment, which is usually scheduled within 7 days.

At the second appointment, the temporary filling is removed and we will then make sure that the inlay or onlay fits correctly. Once fitted properly, the inlay or onlay will be bonded to the tooth with a strong composite resin and polished to a smooth finish.

Considerations for inlays and onlays

Traditional fillings can reduce the strength of a natural tooth by up to 50 percent as well as being unattractive. As an alternative, porcelain or composite inlays and onlays, which are bonded directly onto the tooth using special high-strength resin, can actually increase the strength of a tooth by up to 75 percent and can last from 10 to 30 years. In some cases, where the damage to the tooth is not extensive enough to merit an entire full crown, inlays and onlays can provide a very good conservative alternative.


In the past, teeth were filled with a mixture composed of amalgam of different metals composed of silver and mercury with trace amounts of other metals. Amalgams and gold have proved to be durable and in the case of amalgams, relatively inexpensive, but have lacked the aesthetic appeal that most people would prefer today. Due to advances in technology as well as material science, composites and porcelain materials are available that replicate the appearance of the natural tooth as well as allowing Dr’s. Schwartz and Berman a conservative approach into restoring the teeth in an aesthetic manner.