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  • Overlays Vs Crowns
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A full ceramic crown preparation removes 70-75% of the weight of the coronal tooth structure
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Full crown preparations generally result in the removal of the hard outer enamel of the tooth
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An Overlay preparation removes in 32-47% of weight of the coronal tooth structure and results in greater distance between the restoration & the nerve – both factors are correlated with a decrease in risk of future root canal treatment
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Cusp sparing Onlay preparations result in even less tooth structure removal
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Here is what a tooth looked like underneath an old relatively well “sealed” metal crown
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Here is what a tooth looked like underneath a 15 year old fractured onlay – notice the tooth is still clean and sealed from the adhesive resin used for bonding
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Here is a metal crown that had a lot of decay underneath, unfortunately even though this had been leaking for years, the mechanical retention of the crown keptunderneath it in place masking the extent of decay growth
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Overlays & non-retentive ceramic Onlays will debond (pop off) or break if a significant gap is formed & leakage occurs – additionally X-rays can see through ceramic restorations unlike metal, so decay processes can be spotted more early
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Which of these two preparation designs look better able to handle a load? Which looks stronger and more resilient to fracturing?
After removal of this failing filling notice the large crack underneath the lingual cusps.
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Dr. Schiffenhaus removed the large cracks in dentin as well as decay. He then prepared the tooth for an Overlay – sparing a large amount of healthy tooth structure and enamel. The tooth was bonded with the Immediate Dentin Sealing technique & a ceramic Overlay was bonded over the top. Note the amount of remaining tooth vs a traditional crown preparation.