Overview: This article provides the Instructions for Use (IFU) for Dandy metal inlay and onlay restorations, including indications, risks, and maintenance guidelines. Use this guide to ensure proper clinical application and long-term restoration success for patients.
Indications for Metal Inlays and Onlays
Metal inlay and onlay restorations are designed to restore worn, decayed, or broken dentition. These restorations are specifically used to:
Restore single, permanent teeth that are fractured, carious, or severely worn.
Restore the form and function of natural dentition.
Provide occlusal stability and maintain proper interarch relationships.
Provide a conservative preparation option compared to full crowns and bridges.
Contraindications and Risks
The treating clinician must evaluate the following patient factors before using metal inlays or onlays:
Periodontal Health: Use caution in patients with uncontrolled periodontal disease, severe bone resorption, or oral lesions.
Metal Sensitivity Warning: This device contains metal, including nickel. Clinicians must inform patients with metal allergies or sensitivities about these compounds prior to treatment to avoid rare allergic reactions.
Tissue Irritation Warning: Localized irritation of surrounding oral tissues may occur due to individual variability. Monitor patients post-placement for signs of inflammation or discomfort.
General Risks: Inform patients of potential risks, including restoration failure, misfit, tooth breakage, or recurrent caries.
Patient Benefits: Potential benefits include improved speech, comfort, chewing efficiency, and better digestion.
Restoration Fit and Cementation Guidelines
Follow these steps to ensure the metal restoration is properly seated and bonded:
Test Fit: Test the fit of all metal restorations to verify adequate margins and aesthetics.
Radiographic Verification: Take an X-ray to ensure proper adaptation to the tooth structure.
Occlusal Adjustment: Use articulating paper to mark and adjust high spots.
Surface Preparation: Metal restorations require air abrasion with alumina particles to enhance cement adhesion.
Pretreatment: Refer to the Full Metal and PFM Cementation Guidelines for detailed tooth pretreatment and cement recommendations.
Adjustment Recommendations
When adjusting the metal restoration, follow these technical specifications:
Bur Speed: Operate the bur at high speed with minimal pressure.
Temperature Control: Maintain temperature using constant water and air spray to prevent micro-fractures. Air-only handpiece adjustments are not recommended.
Diamond Selection: Use a fine-grit diamond for all adjustments.
Tooling by Surface: Use a football-shaped bur for occlusal and lingual surfaces; use a tapered bur for buccal and lingual surfaces.
Daily Cleaning and Patient Maintenance
Advise patients on the following hygiene practices to maintain the metal restoration:
Brushing: Brush twice daily with a soft-bristled toothbrush and fluoride toothpaste.
Flossing: Floss daily to remove plaque from the restoration margins. A floss threader may be used for hard-to-reach areas.
Mouthwash: Avoid alcohol-based mouthwashes, as they can dry the mouth and increase plaque buildup.
Dietary Habits: Limit hard, crunchy, or sticky foods that could loosen the restoration.
Hydration: Drink plenty of water to prevent gum disease and keep the restoration margins clean.
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 around the margins.
Disposal and Refabrication Procedures
Procedures for disposing of or returning metal restorations depend on the material type:
Precious Metals: Restorations containing precious metals (e.g., gold alloy) that require refabrication must be returned to Dandy. These can be recycled through specialized refiners.
Non-Precious Metals: Restorations made of non-precious metals do not need to be returned to Dandy for refabrication. These can be disposed of through local scrap metal dealers or general recycling.
General Disposal: Never dispose of metal dental restorations in regular trash.