Composite Filling, Inlay/onlay, Crown, or CEREC?

Your question reminds me of a survey once given at a dental conference a number of years ago.  The dentist lecturer passed out paper to all the dentists in the audience, and there were well over one hundred dentists there.  Half of the room had a question on the paper, "If this were your patient, what type of restoration would you recommend?"  The other half had the question "If this were YOUR TOOTH, what type of restoration would you have your dentist place?"

The results were quite revealing!

The great majority of the dentists who were asked the first question said they would recommend a full crown restoration.  However, regarding the dentists who were asked how they would want their own tooth treated almost unanimously said they would want an onlay!

The lecturer then asked each to explain their answer...why?  The first group said that crowns were easier to do, took less time and they had less problems with dental insurance covering them.  The second group of dentists answered that in their own mouths they would want onlays over crowns because there is less drilling of their teeth.  That they knew that the less drilling of the onlays over crown restorations meant that not only would the teeth underneath be stronger, but also there was less chance of tooth sensitivity, pain, gum irritation and rooth canal with the more conservative onlay restorations.

There is a rule of thumb, that composite fillings are most successful when the size is less than 1/3 the width of the tooth and only one or two surfaces are involved.  The next choice for those slightly larger restorations is the inlay, or for larger restorations, the onlay.  Crowns are best reserved for situations where there is significant decay, broken or weakened teeth, large fillings that have failed, etc.  Regarding CEREC, it just depends on how skilled your dentist is placing them.  In our practice our favorite material for inlays, onlays and ceramic crowns is EMax porcelain.  In this day and age, I believe this is the state of the art porcelain material. 

Inlay/onlay are best choice with regards of conservation of tooth structure and longevity provided your decay has not damaged your tooth structure too much. Best of luck

An inlay or onlay is the best choice. I prefer a strong porcelain like emax over Cerec. There is a better more controlled seal with an onlay than a filling. It will last longer and be more cosmetic as well.

Going with an ilany/onlay is a good compromise and more conservative than a crown.  It also does not wear as fast as composite