If you have been following me on twitter the last few days, then you have heard me talk about this gold inlay that I’ve been working on. Some of the predental students reading this may be asking “what in the world is a gold inlay?” You have come to the right place to find that out.
Inlays are for the posterior teeth and include the occlusal surface (chewing surface) and may also include the proximal surfaces of the tooth. An inlay can be used instead of an amalgam or resin in cases where the caries extended more lingually (towards the tongue) or buccally (towards the cheek). Using an inlay also allows for the dentist to shape the proximal (between the teeth) surface more easily because it is made on a model and not in the patient’s mouth.
I won’t torcher you with the details of creating an inlay but I will tell you that it is a cool experience. The gold is very expensive so the key is not to lose or waste it. The following are a few pictures I snapped while in the lab.
This is what the inlay looked like, right after the gold was cast. The stem on the marginal ridge was actually longer but I cut it down. The next thing to do is to continue trimming the stem down by using a high-speed handpiece with a carbide bur or other instrument of choice. Be careful, though, the gold can get very hot!
Ready to try it in the model
I just finished cutting down the stem and blending it in with the marginal ridge. I did a little bit of polishing to make it look decent and now it is time to try it in the model. The most important thing is to have proximal contact with the adjacent tooth. Some of the other minor problems such as a high marginal ridge can be fixed once it is on the model.
Just about complete
The tooth is placed and everything looks good. I polished the tooth a bit more and was in the process of adjusting the height of the marginal ridge. It is a little high which means the patient won’t be able to close down evenly on both sides. The last step is to cement the crown in and do some final polishing!
There you have it. A gold inlay on tooth #4!