The filling
is a basic dental restoration. The decayed tooth structure is drilled
out and replaced with a composite (white) or amalgam (silver) filling
material. The Inlay
typically used when the cavity is too large for a simple filling. The
inlay is fabricated as a single, solid piece to fit the specific shape
and size of the cavity. The inlay is then cemented in place.

        Sometimes, a tooth is planned to be restored with an intracoronal restoration,
but the decay or fracture is so extensive that a direct restoration,
such as amalgam or composite, would compromise the structural integrity
of the restored tooth or provide substandard opposition to occlusal
(i.e., biting) forces. In such situations, an indirect gold or porcelain
inlay restoration may be indicated.

        When
an inlay is used, the tooth-to-restoration margin may be finished and
polished to a very fine line of contact to minimize recurrent decay.
Opposed to this, direct composite filling pastes shrink a few percents
in volume during hardening. This can lead to shrinkage stress and rarely
to marginal gaps and failure. Although improvements of the composite
resins could be achieved in the last years, solid inlays do exclude this
problem. Another advantage of inlays over direct fillings is that there
are almost no limitations in the choice of material. While inlays might
be ten times the price of direct restorations, it is often expected
that inlays are superior in terms of resistance to occlusal forces,
protection against recurrent decay, the precision of fabrication,
marginal integrity, proper contouring for gingival (tissue) health, and
ease of cleansing offers. However, this might be only the case for gold.
While short term studies come to inconsistent conclusions, a
respectable number of long-term studies detect no significantly lower
failure rates of ceramic or composite inlays compared to composite
direct fillings. Another study detected an increased survival time of
composite resin inlays but it was rated to not necessarily justify their
bigger effort and price.

        In
theory, these two can often be used interchangeably, but inlays are
typically reserved for much larger cavities. They both involve removing
the existing cavity with a drill and filling that empty space, but how
that space is filled is where they primarily differ. With a filling, an
amalgam or composite material is used to fill the space, and it’s a much
quicker process, involving only a single visit.

        With an
inlay, space is filled with a single, solid piece that is usually
fabricated in a lab, although they can sometimes be made in-office, and
they are typically made out of a material like gold or ceramic. The
inlay must be made precisely to the shape and size of the empty space,
otherwise, food and bacteria will enter the space, resulting in further
decay. The upside to an inlay is that they do not contract to the same
degree as a filling after being placed, so there is less chance of the
restoration failing for that reason, or creating a gap between the
filling and the surrounding tooth structure. Inlays also create a
tougher and theoretically more durable surface for use when chewing, and
as such, an inlay should be more reliable long term, although the data
on that is mixed and inconclusive.

        Aside from an inlay
being more expensive than a filling, the number one reason they are very
rarely seen is that dental insurance almost never covers them. The
inlay will be downgraded to a filling by the insurance company (or in
other words, the insurance company refuses to pay for an inlay and will
only pay the price for a filling), resulting in either the dentist
losing money or the patient being given a bill. As such, inlays are
typically reserved for patients without insurance or patients that fully
understand the additional cost above a filling.

        Don't
hesitate to contact BIA Dental Center to get more information about
Filling and Inlay/Onlay and what the difference between. Come and visit
us at Jln. Sunset Road NO. 86A Seminyak, Kuta, Badung, Bali, Indonesia.