Is it a wise choice to replace white fillings with porcelain inlays?

Question

Hi Doctors, I have white fillings in 5 of my molars. Will it be better to replace them with porcelain inlays to assure longer durability? And another question: how long have inlays been available? Are they new in dentistry? Why not always resort to them instead of root canal treating the teeth or as a preventative of root canals? Thank you.

Sarah Thompson, DMD · Answer

On numerous occasions, I've been asked questions similar to the ones you're asking now.  The short answer is that inlays are way more durable than composite filings, they have been around for at least 2 decades that I know, and they can prevent the need for root canals later, but are not a substitute for a root canal.  The long answer is as follows:In the 10+ years that I have been providing cosmetic dentistry, I have placed several thousand porcelain restorations.  I can tell you that inlays are older than composite fillings.  Inlays date back over 50 years, when dentists were placing gold inlays, crowns and bridges.  Advancements eventually led to dentist placing porcelain over these gold restorations for what is called "porcelain-fused-to-metal," commonly known as a "PFM."  It was not long before dental ceramists starting creating full porcelain restorations, and the newer, more durable Zirconia restorations.  (Zirconia is the same substance used to make man-made diamonds, known as cubic zirconias).  For molar teeth (i.e., back teeth), I always like to place zirconia inlays, crowns or bridges because they have about 80% the strength of a actual diamond.  This doesn't mean that they cannot fracture, but it makes them very unlikely to fracture.  Composites fillings will stain 100% of the time and they will almost always leak over time.  I consider composite filling to be a inexpensive, temporary, less reliable alternative to inlays.  I definitely recommend inlays over composite.I hope this helps.  Porcelain veneers, crowns and inlays are what I do, so follow me if you have more specific questions.Sarah Thompson, DMD

Norman Huefner, DDS · Answer

I would say that it would depend on the size and condition of your existing white (tooth colored) fillings.  Typically if the filling is just a single surface (the top of the tooth) and less than 1/2 to 1/3 the width of the top of the tooth, tooth colored fillings are very adequate and will last for years.  However, realize that tooth colored fillings are a type of plastic and not nearly as durable as porcelain restorations used in inlays, onlays and crowns.Without seeing your teeth, I would generally say that it is better to have porcelain inlays and onlays rather than large tooth colored fillings, or fillings that are done on 3 or more surfaces of the teeth.Inlays and onlays have been in dentistry for decades!  However, they were done in gold.  In the 1980s and 1990s porcelain restorations that can be bonded to the teeth started to be the treatment of choice over gold, and remain so today.  Of particular note, my favorite porcelain material is EMax porcelain, which is extremely strong, and as such, can expected to last a very long time, if not a lifetime!

Neil Elman, DDS · Answer

Although composite fillings should last a very long time, porcelain inlays provide the most durability. If money were no object I would only want inlays or onlays in my mouth as opposed to fillings. That said, porcelain inlays are more expensive than composites which may or may not be a factor in one's decision

Albert Kurpis, DDS · Answer

If your goal is to have the BEST inlay possible then that would be a gold inlay or porcelain fused to gold inlay.  Porcelain inlays are a good second but do have limitations which depending on the circumstances in which they are used.

Is it a wise choice to replace white fillings with porcelain inlays?

Answers (4)

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