Partial crown - onlay or CAD/CAM dentistry alternative?

buglawton

To fix a broken off back part of a molar (that already had a large filling) my dentist first tried to patch it, this fell off after a few days. Now she recommends a partial crown.

I'd like to examine the more conservative alternatives, especially something like a CAD/CAM onlay, something that would leave as much old tooth material behind as possible.

Specialists who could examine the tooth and discuss this possibility seem far & few between (from a quick Google of Southern UK ones).

Going to discuss this properly with my dentist this week, but at the same time, is there a register of such specialists?

Anyone else on this board tried onlays or CAD/CAM dentistry as an alternative to a crown?

coldstreamalways

It's not a "specialty" so,I think you'll struggle to find a register of such dentists. Your own dentist might know someone who does crowns or onlays using CAM. you need to discuss this with your dentist.

brook2jack

cad cam crowns/onlays are often not the most conservative way to preserve a tooth as they require a certain thickness of tooth to be removed as these materials are not very strong in thin section.


A three quarter partial crown , particularly in gold, is often the most conservative as gold only needs to be 0.6 mm thick. A well fittinh gold inlay/crown is one of the most durable ways of restoring a tooth.

welshdent

It's not the cad cam that is conservative it's the choice of restoration. Cad cam just means you can have it sooner. In years gone by perhaps but these days there is no reason a dentist can not do the same restoration through a lab. I routinely do onlays and prefer them in most situations to full crowns. I do now have a cerec unit butonly for aa few days. Prep and impression for the lab can do it, ask your own dentist what they think as they have seen your unique situation

buglawton

Thanks for the answers.
Well I'm still learning here...

Missus has indicated against gold which I had already preferred due to durability.
She prefers white - thinks gold makes you look old and I suppose it could glint rather obviously even from the top/back of a rear lower molar (2nd from end).

I think my main choices are the partial crown and the onlay, material notwithstanding. Only my dentist has not mentioned onlays.

Will discuss these 2 options with my dentist and not rush into it if I think she does not have the experience to decide the most optimal solution. I'm really not keen on have a tooth reduced to a stub so a crown can be plonked on top.

buglawton

Update - spoke with dentist again and she seems to be pushing for a part crown, the only thing to discuss is the price, so I go for that chat tomorrow.

I'm going to ask to be assessed for an onlay anyway.
However, from some online research, I see no examples of onlays that include the replacement of a chip off the back surface of the tooth.
So really I want assessment from someone who is well familiar with the limits of what onlays can achieve. May ask for a referral.

brook2jack

Onlays,capped cusp inlays, three quarter crowns are all variants on a theme . The internet is terrible for researching dentistry and photos will by no means show the thousands of different shapes of cavity design.

However what does strike me is you have no trust in your dentist or their professional opinion.

This is not a good place to be in . Inlays/inlays three quarter crowns, though technically demanding are part of the "bread and butter" of dentistry. You are taking into consideration your wife's opinion (white not gold) which may not be a clinically best decision but not your dentists.

You would be better off finding a general dentist whose clinical judgement you trust. A relationship between a patient and dentist is a very personal thing and its important your long-term care is in the hands of someone you trust.

Cad cam techniques have pluses and minuses, some dentists swear by cerec others just swear at it. However restoring one tooth really shouldn't be a specialist job. It just needs a dentist you trust.

buglawton

I think my issue is that the dentist recommended a part crown instantly without going into any detail. Once I've had a proper chat things may look different.

buglawton

Update: the partial crown was done with minimal removal of tooth substance, in fact it's like a big filling but got inserted in one ready made piece so it fills the back gap as well. All in all quite happy.