Indirect Composite Inlays Restoration - A Case Report
Indirect Composite Inlays Restoration - A Case Report
Indirect Composite Inlays Restoration - A Case Report
Author’s Affiliation: 1Dean & Head, 2Senior Resident, Department of Dental Sciences, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India. 3Professor & Head, Department of
Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences & Hospital, Kankarbagh, Patna, Bihar
800020, India.
Corresponding Author: Nidhi Singh, Senior Resident, Department of Dental Sciences, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
E-mail: [email protected]
Received on 18.01.2020; Accepted on 15.02.2020
Abstract
The evolution of esthetic dentistry perseveres through innovations in bonding agents, restorative materials,
and conservative preparation techniques. The utility of direct composite restorations in posterior teeth is
confined to relatively small cavities owing to polymerization stresses. An esthetic alternative to ceramics when it
comes to posterior teeth in indirect composite. Since their first application, numerous advancements have been
made in adhesive dentistry. In 1980s, indirect resin composites were introduced with Touati and Mormann
developing the first generation of indirect resins composite. Further, improvements in structure, composition and
polymerization techniques led to the introduction of a second-generation of indirect resin composites. These
include Artglass (Heraeus–Kulzer), Belleglass HP (Kerr), Targis (Ivoclar), Columbus (Cendreset Matrux) and
Sinfony (ESPE). Indirect resin composites offer optimal esthetic performance, enhanced mechanical properties
and reparability. These characteristics allow them to be used in a wide range of clinical applications, such as
inlays, onlays, crowns, veneering material and also fixed dentures prostheses. This paper presents the two case
reports of patients, treated with indirect composite inlays.
Keywords: Esthetic dentistry; Indirect composite restorations; Inlays.
oral cavity leading to lesser stress at tooth surfaces of tooth 47 (Fig. 1). The preoperative IOPA
restoration margin which results in less radiograph revealed of large radiolucency involving
microleakage, less marginal breakdown, less the enamel and dentin in 47. Pulp was vital on
postoperative sensitivity and less marginal performing
staining. Moreover, it is easier to achieve ideal
proximal contacts and anatomic morphology using
indirect restorations.
In spite of having mechanical properties
inferior to those of ceramics, in some clinical
situations, indirect resin composites can
supplement and complement ceramic
restorations: for example, in coronal restoration
of dental implants. Since ceramics have a high
modulus of elasticity and absorb less of the
masticatory energy, a substantial amount of this
force is transferred to the implant and
periosseous structure, thus reducing the longevity
of restoration. The materials of choice in such
situations and polymers as they absorb relatively
more of this occlusal force. Therefore, stress
absorbing materials like indirect resin composites
are recommended for patients with poor
periodontal structures who require occlusal
coverage.3 Compared to ceramic materials,
indirect resin composites exhibit better stress
distribution, repairability, lower cost and ease of
handling.4
Now-a-days, patients are more inclined
towards tooth-coloured restorations, and here
too, indirect resin composites prove more
advantageous than other materials like cast gold
restorations. Owing to their characteristics,
indirect resins composites cover a large span of
indications including inlays, onlays, overlays,
short-span xed denture prostheses (FDP),
veneering material of FDS’s and removable
dentures and as a repair material for a variety of
restorations.
This paper aims to review some of the
applications of these materials and discuss clinical
cases to illustrate the scope of utilizations of indirect
resin composites.
Clinical Presentation
Case A
A 21-year-old male reported to the Department of
Conservative Dentistry and Endodontics, Buddha
Institute of Dental Sciences and Hospital (Patna,
Bihar) with the chief complaint of food lodgments
and sensitivity due to cold in lower right posterior
tooth region. On clinical examination, Class I
caries were seen on the occlusal and buccal
Indian Journal of Dental Education, Volume 13 Number 1, January – March
2020
Indirect Composite Inlays Restoration: A Case 2
Report
pulp vitality test. So, the diagnosis was reversible
pulpitis and we went for conservative
restoration,
i.e. indirect resin composites inlay with cusp
capping.
Clinical Procedure
Cavity preparation was done in accordance with
preparation guidelines for inlay restorations: no
sharp angles; no wide isthmus; slightly ared
walls 8–10; no chamfer preparation; and a
minimum preparation depth of 1.5 mm. The
extension of caries from a primary groove
towards the mesio-buccal cusp tip was more
than two-thirds of the distance. Therefore, cusp
capping was indicated. Areas prepared closer
than 0.5 mm to the pulp should be lined with
calcium hydroxide, and undercuts were
lled with appropriate liner or base (Fig. 2).
Laboratory Procedure
Two models prepared from impression (Fig. 4), one
was for inlay fabrication and the other for tting
and occlusal adjustments and mounted on dies to
facilitate the layering process. A die spacer (Ivoclar
Vivadent) was applied into cavity and dried for 2 to
3 minutes (Fig. 5).
Cementation
Case B
A female patient come to the department with the
chief complaint of food lodgement and wants to Fig. 19: Inlay was cemented.
replace the restoration in 36 (Fig. 16).
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Indian Journal of Dental Education, Volume 13 Number 1, January – March
2020