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  • Writer's pictureDr. Neish

Choosing the Right Restoration: Dental Crowns or Onlays

“If your only tool is a hammer, every problem will look like a nail.”

Unfortunately, this is the case for so many dentists who do not possess the knowledge, training, and modern technology to approach tooth restorations in a conservative and biologically conscientious manner. The result can be unnecessary removal of tooth structure and the trauma that it imparts. This perpetuates the “life cycle” of a tooth in a traditional approach to dentistry - small filling, big filling, crown, root canal, extraction, implant. Ideally we would focus on preventative care and avoid this progression entirely. But what happens when a tooth has experienced more significant structural damage and a restoration larger than a filling is necessary?

Two common procedures are dental crowns and onlays, which serve distinct purposes in preserving the structure and functionality of teeth. In this blog post, we will explore the dissimilarities between dental crowns and onlays and shed light on when each option is appropriate.

dental crown

Dental Crowns:

A dental crown, also known as a cap, is a protective covering that encases the entire visible portion of a damaged or decayed tooth. These restorations are typically recommended for teeth that have extensive structural damage, fractures, or large cavities and decay.

Key Characteristics of Crowns:

1. Coverage: Dental crowns cover the entire tooth, extending above the gum line, which provides maximum protection and support for heavily damaged teeth.

2. Strength and Durability: Crowns are designed to withstand biting forces and protect weakened teeth from further damage.

3. Cosmetic Enhancement: Crowns can also improve the appearance of severely discolored or misshapen teeth, enhancing the overall aesthetics of the smile.

4. Extensive Tooth Preparation: To accommodate the crown, a significant portion of the tooth's structure is removed and reshaped to create a suitable base for the restoration.

5. Treatment Duration: Traditionally, crown placement typically requires two dental visits, with a temporary crown worn between appointments while the permanent crown is fabricated in a dental laboratory. In our office, we complete the process start to finish using advanced technology to design and fabricate your permanent crown the same day. Quick and efficient with no temporary crowns to deal with.

dental onlay

Dental Onlays:

Onlays, also known as partial crowns or overlays, are restorations that are used to repair and protect teeth with moderate levels of damage or decay. Unlike dental crowns, onlays do not cover the entire tooth surface but instead extend over one or more cusps (the pointed edges of the tooth). Onlays are commonly made from porcelain ensuring a natural appearance and a secure fit.

Key Characteristics of Onlays:

1. Conservative Approach: Onlays preserve more natural tooth structure compared to crowns, as they only cover the damaged or decayed portions of the tooth.

2. Strength and Functionality: Onlays are highly durable and can restore the strength and functionality of the tooth, enabling normal chewing and biting.

3. Aesthetic Appeal: Onlays are custom-made to match the color and shape of the natural tooth, blending seamlessly with the smile.

4. Minimal Tooth Preparation: Onlays require less tooth preparation, as only the damaged areas are removed, allowing for a more conservative approach compared to crowns.

5. Treatment Duration: Using the same advanced technology, onlays are completed in one visit. This not only adds convenience, but also allows for even more conservative shaping of the tooth where such a design wouldn’t be possible when requiring a temporary restoration. A traditional approach to onlays requires two visits, like crowns, and often preserve less tooth structure.

dental restorations

Choosing the Right Restoration:

The decision between a dental crown and an onlay depends on the severity and location of the tooth damage. Dental crowns are typically recommended when a tooth has extensive structural damage, such as large fractures or decay, while onlays are suitable for cases where the damage is more moderate and confined to specific areas of the tooth. Sometimes a crown is recommended because it is the only tool in the tool belt. Once tooth structure is removed it is gone for good, so make sure you are working with someone who is knowledgable about both types of restorations.


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