Many patients have large silver (amalgam) fillings and they may last for many years or decades. Several things can happen to silver fillings over time though, including:
- Staining or discoloration of the healthy surrounding tooth structure
- Corrosion leading to leaking margins
- Decay along the leaking margins or under the silver filling
- Cracks in the healthy surrounding tooth structure
- Chipping, cracks, or even loss of the silver filling itself
This patient had a large silver filling that was more than half of the chewing surface of the tooth and had a leaking margin with decay underneath the filling. After discussing the options we opted for a tooth colored ceramic onlay.
Onlays are partial crowns that offer some advantages over large fillings or full crowns including:
- Ceramic is a stronger material than most tooth colored filling materials
- Onlays can cover some or all cusps of a tooth offering protection from chewing forces
- Onlays conserve more natural tooth structure
- Lab fabricated onlays offer better shape and contours than some large fillings, making it easier to keep clean and healthy
- Onlays are often less expensive than a full crown
The drawbacks of an onlay are that they take two visits, can be more expensive than a traditional tooth colored filling, and can be very technique sensitive. Dr. Appel has taken many advanced restorative courses with Spear Education as a member of their Faculty Club and uses Midwest Dental Arts which is one of the finest laboratories in the country.
Over two visits we were able to remove the old silver filling, replace the decay and missing tooth structure with a composite buildup material, prepare the tooth for an all ceramic tooth colored onlay, and then deliver the final all ceramic tooth colored onlay blending in naturally with the adjacent teeth.