20 November 2019

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Inlay and Onlay VS Crowns: which guarantees the longest survival?

Simona Chirico

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The use of restorative materials to adhere to the dental surfaces and to preserve as much dental tissue as possible, has determined and conditioned the choice of the dentists in rehabilitating teeth with caries or abrasions. We are increasingly opting for partial indirect restorations compared to the total ones, allowing, in this way, to restore not only the functionality of the single element, but also to guarantee aesthetics. But are these types of partial restorations, such as inlays and onlays, as reliable as the classic crowns? What is their survival over time? The study by Vagropoulou et al confirmed that these restorations are as safe as crowns, analyzing the 5-year survival rate.  

Materials and methods
An electronic search was performed in various electronic databases to identify articles, published between 1980 and 2017. A total number of 2849 papers were retrieved initially, but only 9 studies were selected for inclusion. The heterogeneity of the studies did allow neither a meta-analysis nor any meaningful comparison between types of restorations or materials.  The search terms were splited into 4 groups: inlay, onlay, inlay+onlay, crown. They analyzed the 5-year survival rate and the complications of failure.  

Results
The mean survival rate was for:
Inlays: 90.89%
Onlays: 93.5%
Inlay + Onlay: 99.43%
Crowns 95.38%  

Statistical analysis demonstrated caries to be the main biological complication for all types of restorations, followed by root fracture  and endodontic problems. Ceramic fractures represented the most common technical complication of the material restoration, followed by loss of retention and porcelain chipping.

Conclusion:
The 5-year survival rate for inlays, onlays and crowns is very high, exceeding 90%. So indirect partial restorations are a good alternative for the total ones.  

For additional informations:  Complications and survival rates of inlays and onlays vs complete coverage restorations: A systematic review and analysis of studies Complications and survival rates of inlays and onlays vs complete coverage restorations: A systematic review and analysis of studies