Porcelain veneers are used to modify the shape and color of teeth, and they are the treatment of choice for teeth that are relatively intact but may be misshapen, discolored, or chipped. Veneers are thin shells of porcelain that are internally etched and then bonded to the enamel of the teeth.
A small amount of tooth structure must be removed to make room for the porcelain veneer and to avoid making the tooth look big and bulky. The tooth preparation is limited to the enamel and usually involves only a few surfaces of the tooth, unlike a crown. A prosthodontist uses porcelain veneers to improve the appearance of teeth and to close spaces or gaps between teeth if necessary.
Inlays or onlays are excellent restorative options when the existing failing restoration or the extension of the posterior tooth damage makes a conventional filling or a crown contraindicated. The difference between an inlay and an onlay is the type of coverage of the restoration. An inlay only restores the inner portion of the tooth that is missing or damaged, whereas the onlay not only restores the inner portion, but additionally covers major surfaces of the biting surfaces of the tooth. The dentist will determine if an inlay or an onlay is indicated based on the extent and location of the tooth damage. Inlays and onlays are often made of tooth-colored materials or high noble metal alloys. These materials have been found to have compatible properties in flexural strength to enamel and dentin, therefore making them excellent materials where indicated. This type of procedure requires that the restoration be fabricated outside the mouth on a model of the prepared tooth/teeth; hence, an impression is necessary.
Fillings replace lost tooth structure due to dental decay or minor fractures of the tooth. In simple cases, the missing tooth structure can be replaced with dental fillings using composites or amalgam. With further loss of tooth structure, crowns and onlays may be required.
Composite restorations are tooth-colored fillings that are bonded to tooth surfaces to fill cavities, build, reshape, or change the color of teeth. These type of restorations are most commonly used in the esthetic zone of the mouth.
Amalgam restorations, also known as “silver fillings”, are a combination of metals. Amalgam has been used for many decades safely with a high success rate and no proven side effects. It is one of the most reliable materials used to restore teeth. These restorations can also be bonded to the prepared surfaces of the tooth.