Should Inlays or Onlays Replace Crowns for Root-Canaled Teeth?

Q: Should Inlays or Onlays Replace Crowns for Root-Canaled Teeth?

Hello： The greatest advantage of inlays is that their margins are located above the gum line, making them easy to clean and clearly visible. <br>However, the downside is that they require a high level of skill from the dentist or technician; if not done properly, they are prone t

The issue of inlays/onlays as alternatives to crowns?

Hello Dr.
Lin, I have a root canal-treated upper premolar.
The dentist mentioned that there is still a significant amount of remaining tooth structure, so an inlay/onlay could be used instead of a crown.
Another clinic also assessed that an inlay could be done, but the shape and the amount of tooth structure that needs to be removed would be quite similar to that of a crown.
They suggested that an inlay might be slightly better.
My concern is whether the inlay might easily come loose or lack sufficient protection.
I have seen some cases online where poorly made inlays have fallen out.
I would like to ask, if the inlay/onlay is crafted by a skilled technician and the cost is similar to that of a crown, would you recommend using an inlay instead of a crown? Thank you!

MIKE Zhao, 40~49 year old female. Ask Date: 2021/12/18

Dr. Lin Jiayong reply Dentistry

Hello: The greatest advantage of inlays is that their margins are located above the gum line, making them easy to clean and clearly visible.
However, the downside is that they require a high level of skill from the dentist or technician; if not done properly, they are prone to failure.
If your dentist informs you that you can have an inlay, it is advisable to proceed with it (as it conserves more tooth structure).
If it fails in the future, there will still be an opportunity to switch to a crown.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/12/18

More Info

When considering whether to use inlays or onlays instead of crowns for root-canaled teeth, it's essential to weigh the benefits and drawbacks of each option based on the specific dental situation. In your case, since you have a root-canaled upper premolar with a significant amount of remaining tooth structure, opting for an inlay or onlay could indeed be a viable choice.

Understanding Inlays and Onlays:
Inlays and onlays are custom-made restorations that are used to repair teeth that have been damaged by decay or trauma. They are typically made from materials such as porcelain, composite resin, or gold. The primary difference between the two is that inlays are used for damage that is confined to the center of the tooth, while onlays extend over one or more cusps of the tooth.

Advantages of Inlays and Onlays:
1. Conservation of Tooth Structure: One of the most significant advantages of inlays and onlays is that they require less removal of healthy tooth structure compared to crowns. This is particularly beneficial for teeth with substantial remaining structure, as it helps preserve the natural tooth.

2. Aesthetic Appeal: Inlays and onlays can be made from tooth-colored materials, providing a more natural appearance compared to metal crowns. This is especially important for visible teeth, such as premolars and anterior teeth.

3. Strength and Durability: High-quality inlays and onlays can be very durable and can withstand significant chewing forces. When properly placed, they can provide excellent protection for the tooth.

4. Less Invasive: The procedure for placing inlays and onlays is generally less invasive than that for crowns, which can lead to a quicker recovery time and less discomfort.

Concerns Regarding Inlays and Onlays:
1. Risk of Dislodgement: While inlays and onlays are designed to be secure, there is a risk of them coming loose, especially if the fit is not precise or if there is significant wear over time. However, when crafted by a skilled technician and bonded correctly, this risk is minimized.

2. Potential for Insufficient Coverage: If the tooth has extensive damage or if there is a risk of further decay, a crown may provide more comprehensive coverage and protection. Crowns encase the entire tooth, offering more support than inlays or onlays.

3. Cost Considerations: While you mentioned that the costs for inlays/onlays and crowns are similar, it's essential to ensure that the quality of materials and the expertise of the dental technician are comparable. Sometimes, lower-cost options may not provide the same level of durability or aesthetic appeal.

Conclusion:
Given your situation, if the remaining tooth structure is adequate and the inlay/onlay can be crafted with precision, it could be a suitable alternative to a crown. Inlays and onlays can offer a balance of aesthetics, conservation of tooth structure, and durability. However, it is crucial to have a thorough discussion with your dentist about the specific risks and benefits in your case, including the potential for future issues and the longevity of the restoration.

Ultimately, the decision should be made collaboratively with your dental professional, considering your specific dental health, aesthetic preferences, and financial considerations. If you feel confident in the skills of the technician and the materials being used, opting for an inlay or onlay may be a beneficial choice for your root-canaled tooth.

Similar Q&A

Choosing Between Dental Crowns and Inlays for Root Canal Teeth

Hello, About two years ago, I underwent root canal treatment on my upper first molar due to decay. The tooth was not painful, but it was very close to the pulp chamber on the X-ray, so root canal treatment was necessary. The procedure went well, but I did not have a post and cr...

Dr. Zeng Guanghui reply Dentistry
1. If there is enough support, a crown can be placed directly. 2. If there is still a significant amount of tooth structure remaining and the area of loss is small, a porcelain inlay can be considered; otherwise, a crown is preferable, as teeth that have undergone root canal trea...

Understanding Costs and Material Choices for Dental Crowns and Inlays

Hello, Doctor. About a month or two ago, the filling on my last lower right tooth fell out. After evaluation, the doctor determined that it was not suitable to refill, but there was no need for a root canal treatment. Therefore, I opted for a porcelain inlay (out-of-pocket cost o...

Dr. Huang Tingfang reply Dentistry
Dear Anonymous Miss: Hello! Whether to perform a root canal treatment is determined by the physician, mainly due to symptoms such as pain when drinking hot water, sensitivity to touch, and continuous pain lasting over an hour. For the posterior teeth, you can choose a metal crown...

Should You Fill or Crown Your Tooth After Root Canal Treatment?

If a doctor has performed a root canal treatment on a small molar and the tooth begins to rock back and forth, will getting a dental filling covered by health insurance be effective? Or would it be better to opt for a dental prosthesis at my own expense? What does "dental pr...

Dr. Zeng Guanghui reply Dentistry
If a tooth that has undergone root canal treatment is still loose, it is important to consider the possibility of periodontal disease. It is recommended to treat the periodontal disease first before considering dentures or fillings. Dr. Tseng Guang-Hui, Department of Dentistry, N...

Exploring Dental Solutions: Implants vs. Crowns for Damaged Teeth

I have a tooth that is almost devoid of enamel, and the crown is very short. The doctor told me that the root is slightly inflamed and suggested either dental implants or grinding down the adjacent teeth to create a three-unit bridge. Are these the only two options available?

Dr. Zeng Guanghui reply Dentistry
In the above situation, if the root length is sufficient and there are no root pathologies, it may be considered to first perform a root canal treatment, followed by the placement of a post and crown.