Traditional Dental Crowns vs Conservative Porcelain Onlay

How do dentists fix a tooth that is damaged beyond what a dental filling can support?

A tooth that has sustained large damages either due to cavities or fractures, is commonly fixed by protecting the tooth with a crown. To do a dental crown, the entire enamel layer of the tooth has to be shaved away so that the crown can take its place. In this method, often times a lot of healthy tooth matter is removed beyond that of the cavity/fracture to retain a crown onto it. In this method, the tooth is reduced so as to gain a mechanical retentive features so that the crown can stay attached to the tooth.

Fortunately, there’s a better way! With modern materials, and advanced dentistry knowledge & techniques, only the damaged aspect of the tooth can be replaced. In this fashion, the strength of the tooth is preserved and the life of the tooth extended. This method is only possible because we are utilizing advanced bonding methods which allows us to attach the porcelain to the tooth at the same strength that enamel attaches to the underlying tooth structure. Therefore, no extra tooth matter needs shaving to achieve mechanical retentive features. A dental crown should be the very last option.

In this video, Dr. Shayesteh delivers/ instals a ceramic onlay, also known as a BioDome Overlay under an operating dental microscope.

This type of restoration instead of a traditional crowns provides several advantages.
1. Only the damaged top of the tooth is treated
2. The rest of the tooth, also referred to as the BioRim is preserved and therefore the rigidity & strength of the tooth is preserved.
3. The preparation design and the resulting effects of the restoration converts the tensile stresses on the tooth to compressive forces. Compressive forces are kind as apposed to tension stresses.

The teeth are isolated with gold standard rubber dam isolation, gold standard materials are utilized, and all aspects of this procedure are scientifically evidence based.

Dr. Graeme Milicich, a world expert in tooth biomechanics, teaches that the enamel is like a compression dome similar to a cathedral dome. The overlying compression dome will protect the underlying dentin from damaging tensile forces.

Much appreciation & gratitude to my stellar mentors, Dr. Thomas Basta & Dr. Jeff Brucia, masters, gurus, and exemplars in the field of Occlusion & Advanced Dentistry.

Three years of advanced training & guidance with them at F.A.C.E. has given me the most current evidence based dentistry knowledge, guidance, support and confidence to deliver Dental Excellence!

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