Overview: This article provides comprehensive instructions for use, contraindications, cementation guidelines, and maintenance for Dandy’s ceramic Inlay and Onlay restorations.
Indications for Use
Dandy’s Inlay and Onlay restorations restore worn, carious, broken, or aesthetically unpleasing dentition.
Fracture and Decay: Restores single permanent teeth that are fractured, discolored, or severely worn.
Function and Esthetics: Restores the natural form and chewing function of the patient's teeth.
Stability: Maintains proper occlusal stability and interarch relationships.
Conservative Prep: Offers a more conservative preparation option compared to full crowns or bridges.
Safety and Risk Information
Contraindications
Clinicians should use Inlays and Onlays with caution in patients with uncontrolled periodontal disease, severe bone resorption, or active oral lesions.
Warning – Sensitivities and Irritations
Cobalt and Chromium: This ceramic material contains trace levels of cobalt and chromium oxides. Clinicians must inform patients with known allergies to these compounds prior to treatment.
Tissue Response: Localized irritation of oral tissues may occur. Clinicians should monitor patients post-placement for signs of inflammation or discomfort.
Restoration and Cementation Procedures
General Test Fit
Test the fit of all restorations to ensure adequate aesthetics and physical adaptation.
Take an X-ray to verify proper adaptation at the margins.
Adjust high spots using articulating paper to mark contact areas.
Zirconia Restoration Cementation
Pretreatment: Bond zirconia using chemical and mechanical protocols, such as air-particle abrasion or tribochemical silica coating.
Sanitization: Sandblast and steam-sanitize all zirconia restorations before placement.
Priming: Use zirconia-specific primers, particularly those containing 10-MDP, for effective chemical bonding.
Emax Restoration Cementation
Methods: e.max restorations support adhesive, self-adhesive, or conventional cementation. Inlays and Onlays are typically cemented adhesively.
Etching: Lithium disilicate restorations require etching before placement.
Silanization: Silanize restorations for adhesive and self-adhesive cementation protocols.
Clinical Adjustment Guidelines
Tool Selection: Use a fine-grit diamond bur at high speeds with minimal pressure.
Temperature Control: Maintain temperature using water and air spray to prevent micro-fractures; do not use air-only handpiece adjustments.
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Surface Shaping:
Occlusal and Lingual: Use a football-shaped bur.
Buccal and Lingual: Use a tapered bur.
Patient Maintenance and Oral Hygiene
Daily Cleaning
Brushing: Brush teeth twice daily with a soft-bristled toothbrush and fluoride toothpaste.
Flossing: Floss daily to remove plaque around the restoration. Use a floss threader for difficult areas.
Mouthwash: Avoid alcohol-based mouthwashes as they can increase plaque buildup.
Dietary Habits
Food Restrictions: Limit hard, crunchy, or sticky foods that could loosen the restoration.
Sugar Intake: Limit sugary foods to prevent new cavities at the restorative margins.
Hydration: Drink plenty of water to help prevent gum disease.
Additional Information
- If the patient experiences any adverse events, such as pain or irritation, they should contact your practice immediately.
- Fixed restorations have a limited warranty, which may vary depending on the manufacturer.
- Smoking with restorations can cause discoloration
Disposal and Recycling
Clinical Waste: If the restoration has contacted saliva or been in the mouth, it must be discarded as biomedical waste.
General Disposal: Ceramic items are typically not accepted in curbside recycling. They can be disposed of in regular household trash or at specialized centers for construction debris.