CATEGORY AUSTRALASIAN DENTIST 79 CLINICAL than transmit the occlusal forces to the remaining tooth structure. u Aesthetics: Crownlays can be blended into the remaining tooth structure. Ideal Cases: Crownlays are suitable for cases where more extensive restorations are necessary but where full coverage crowns would require significant tooth reduction. They can be an extension of the tabletop design into the proximal boxes. 3. Veneerlays: Veneerlays combine the advantages of both veneers and inlays/onlays, covering both the facial and occlusal surfaces of the tooth. They are a highly aesthetic solution for cases where the posterior tooth has either a carious lesion or an existing restoration present on the occlusal and/or the proximal surface. Benefits: u Aesthetics: When compared to a crownlay, veneerlays extend to cover the whole buccal surface for aesthetic cases. Using a veneerlay instead of a full coverage crown, combines the thinness of veneers with the strength and durability of inlays. u Preservation of Tooth Structure: Veneerlays require minimal reduction for aesthetic areas when compared with the traditional alternative of a full coverage crown, making them an ideal option. This minimises the risk of pulpal complications. Ideal Cases: Veneerlays are ideal for teeth where both the facial and occlusal surfaces require enhancement due to aesthetic concerns Traditional inlay or onlays generally restores only the damaged tooth structure be it from caries, a crack, trauma or a preexisting restoration. Benefits: u Preservation of Tooth Structure: Inlays and onlays require minimal reduction. u Improved forced distribution: Lithium disilicate’s high flexural strength is able to absorb the occlusal forces rather than transmit the occlusal forces to the remaining tooth structure. Ideal Cases: Inlays and onlays are ideal when there is no clinical requirement for cuspal protection. A thorough assessment of the remaining cusps is required along with assessment of the occlusal forces onto the tooth. Optimising the Plan for Quadrant Dentistry In quadrant dentistry, the key to success lies in creating a comprehensive treatment plan that balances aesthetic goals with functional requirements. The following strategic principles should guide your planning process: 1. Comprehensive Assessment: Begin by evaluating the entire quadrant to understand the interrelationships between teeth. This involves considering not only the aesthetic desires of the patient but also occlusal harmony, tooth wear patterns, and potential future restorative needs. 2. Minimally Invasive Approach: Whenever possible, prioritise preservation of tooth structure. Materials like lithium disilicate provide strength and aesthetic appeal, but the aim should be to reduce tooth reduction while still achieving the desired functional and aesthetic results. 3. Material Selection: A high strength glass ceramic such as Lithium disilicate is the material of choice for many indirect restorations due to its high strength, aesthetic qualities, and versatility. However, consider the specific demands of each tooth when deciding whether to use a tabletop, crownlay, veneerlays, or full coverage crown. 4. Long-Term Prognosis: Factor in the longevity of the restoration. Indirect restorations made from lithium disilicate provide outstanding longterm outcomes, but planning should account for potential changes in the patient’s bite, wear patterns, and aesthetic preferences over time. Conclusion Indirect quadrant dentistry using lithium disilicate offers an exciting opportunity to provide patients with high-quality restorations that blend seamlessly with natural tooth structure. By embracing a more conservative, bonded approach to restorations, you can achieve excellent functional and aesthetic results while preserving tooth integrity. With careful planning and strategic decision-making, you can optimise your use of this material and elevate the quality of care you provide to your patients. For those looking to deepen their understanding and refine their preparation and bonding skills in indirect quadrant dentistry, further education is essential. Keep an eye out for upcoming courses that will be coming up (www. dentalmasteryacademy.com.au) where we will delve into the finer details of these advanced strategies, giving you the tools to master this advantageous approach to deliver optimal results in your practice. u For more resources and insights, visit www.dentalmasteryacademy.com.au or connect on social media: Instagram: @dr.andrewsee, Email: andrew@dentalmasteryacademy.com.au Dr Andrew See is a highly-trained cosmetic and implant dentist with over 20 years of experience. His practice is focused primarily on aesthetic rehabilitation, implantology and hard and soft tissue augmentation. He completed his Bachelor of Dental Surgery with Honours from the University of Sydney in 2003 and then went on to complete a Postgraduate Diploma in Dental Implantology and a Masters Degree with Distinction in Aesthetic Dentistry through the prestigious King’s College London. Dr See has completed his Fellowship by primary and secondary examination for The Royal Australasian College of Dental Surgeons (FRACDS) achieving numerous commendations for outstanding performance. He has also been awarded Fellowship into the International Congress of Oral Implantologists and the Faculty of General Dental Practitioners in the UK. or functional issues. They are particularly effective in patients with mild to moderate wear, where a full coverage crown will be too invasive. In posterior teeth, veneerlays are a natural adjunct to a case that is being treated with veneers in the anterior region. 4. Traditional Inlay or Onlay:
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