Dentistry Live: dental inlays and onlays questions answered

Is chairside digital dentistry quicker, more conservative and worth the investment? Those were the questions behind Dr Simon Fieldhouse’s Dentistry Live Q&A on dental inlays and onlays.

Following a live demonstration of an inlay/onlay with cuspal replacement, Fieldhouse answered practical questions on milling versus printing, material choice, preparation design, cementation and return on investment.

Milling versus printing

Asked whether printing might be quicker than milling for an inlay, Fieldhouse was direct: ‘No.’

While printing has applications in surgical guides, models and splints, he said post-processing currently makes it less practical for chairside inlays.

‘Realistically the production process, instead of being between three and five minutes, is 15, 20, maybe even 25 minutes, and that’s a lot longer,’ he said.

For dental inlays and onlays, he said hybrid ceramics remain his preferred material.

‘For inlays, hybrids are great,’ he said. ‘I prefer them to ceramic, to be honest, partly because the processing time is a lot quicker.’

Preparation and cementation

On large MOD amalgam premolars, Fieldhouse said he removes the amalgam, places a bonded SDR or composite core, and works to minimum material thickness.

For cementation, he described a consistent protocol: etch, silanate, then Calibra Universal Cement, using Prime & Bond active as the adhesive.

The business case

Fieldhouse also discussed the return on investment from digital dentistry. His practice started with two scanners, one mill, one furnace and a CBCT, before buying a second mill within six months.

‘For the first seven years of us working digitally, we saw a 25% year on year increase in profits,’ he said. ‘And that was including the capital investment.’

Watch the full Dentistry Live session with Dr Simon Fieldhouse on demand now.

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