Inlay cavity preparation by direct and indirect method for the fabrication of prosthesis

inlay wax can be used for direct and indirect techniques for fabrication of prosthesis

1. Inlays

2. Introduction GPT-9

3. Classification

4. Case 1

5. General examination: Patient was conscious, cooperative and well oriented with time place and person Moderately built and nourished.

6. Intraoral examination

7. Diagnosis and treatment plan Secondary caries on proximal surface wrt 26  simple tooth preparation Cast metal Inlay

8. Treatment

9. Retention grooves

10. Case 2

11. General examination: Patient was conscious, cooperative and well oriented with time place and person Moderately built and nourished .

12. Intra oral examination

13. Diagnosis and treatment plan Temporary restorative material undergoing deep caries management  compound tooth preparation ceramic Inlay

14. Case 3

15. General examination: Patient was conscious, cooperative and well oriented with time place and person Moderately built and nourished .

16. Intra oral examination

17. Diagnosis and treatment plan

18. Basic concepts of inlay cavity design

19. Cast metal inlay

20. Advantages & Disadvantages

21. Ceramic inlay

22. Composite inlay

23. Differences Cast metal inlay Ceramic inlay Composite inlay Taper 2°-5° 6°-8° 6°-10° Bevels Indicated Contraindicated Cavosurface angle 140°-150° Butt joint or hollow ground chamfer external cavosurface margins Butt joint or hollow ground chamfer external cavosurface margins Preparation 1-1.5 mm from DEJ 1.5mm-2.0mm 1.5-2.0mm Clearance 0.5mm 0.5 mm 0.5mm Cusp capping 1.5mm reduction Chamfer margin 1.5 -2.0mm Shoulder margin 1.5-2.0mm No feather edge

24. Differences in preparation for cast metal restoration for direct wax pattern No retention grooves No extensions No secondary retentive features No cusp capping Bevel is of greater bulk Gingival bevel  greater width and steeper 1/4 th -1/2 of Mesiodistal width of cervical floor include proximal cervical cavosurface angles use beveled cylinder carbide bur followed by GMT for inlay cutting edge angle 100° for distal GMT and 70 ° for mesial GMT (TB232 and TB233[Tucker gingival marginal trimmer])

25. Inlay holding instruments

26. C ase 1 Bucco lingual width < 1/3 rd intercuspal distance Patient willing to come for 2 appointments Low caries risk patient

27. Case 2 Underwent deep caries management (indirect pulp capping) temporary restorative material  RMGIC Not symptomatic Wanted esthetic restoration (occupation in marketing) Extensive lesion present As cusp capping of distolingual cusp was required  shoulder margin did not specifically lead to excess tooth preparation

28. Case 3 Extensive carious lesion Lot of remaining tooth structure Metal cast inlay/ ceramic inlay  would necessitate cusp capping of distobuccal , distolingual and mesiobuccal cusps Composite restoration allowed conservation of tooth structure Direct composite extensive lesion….harder to create contacts and contours+ c- factor is high polymerization shrinkage Hence indirect composite inlay

29. These restorations are already an excellent choice for the clinicians and in combination with more technologically developed systems of reinforced materials there is a solid optimism for the future application of these restorations

30. References Shillingburg HT, Hobo S, Whitsett LD. Preparations for intra-coronal restorations. In: Hobo S, Whitsett L, Jacobi R, et al. Fundamentals of Fixed Prosthodontics. 2nded. Hanover Park, IL: Quintessence Publishing; 1981. Fligor J. Preparation design and considerations for direct posterior composite inlay/ onlay restoration. International dentistry 12(4):6-15. Aspros A (2015) Inlays & Onlays Clinical Experiences and Literature Review. J Dent Health Oral Disord Ther 2(1): 00038 .