Vital Pulp Onlay Restoration For Extensive Secondary Caries In Molar

Dental defects caused by caries are highly prevalent in clinical practice and can be managed through either direct or indirect restorative approaches. While direct composite resin restorations effectively remove carious lesions and protect the dental pulp, they often inadequately restore the natural occlusal anatomy, functional occlusion with opposing teeth, and proper proximal contacts with adjacent teeth. Additionally, polymerization shrinkage and material degradation are common drawbacks associated with composite resin fillings. intracoronal restorations designed to reconstruct tooth morphology and function, exhibit superior mechanical properties. This case employed a chairside computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic inlay for treatment. Under rubber dam isolation, microscopic tooth preparation was performed, followed by immediate dentin sealing to prevent contamination by saliva and microorganisms. The prepared margins and internal line angles were smooth and continuous. At the two years follow-up, the pulp exhibited normal vitality, the inlay margins were well-adapted, and the surrounding gingival tissue remained healthy, demonstrating favorable clinical outcomes. For vital posterior teeth with extensive defects, conventional full-coverage crowns provide excellent mechanical strength but require significant removal of healthy tooth structure, increasing the risk of pulp exposure and mechanical irritation.Recent advancements in adhesive materials and techniques have significantly expanded the clinical application of onlays. Minimally invasive onlays have emerged as the optimal choice for tooth defects. Clinicians can select appropriate onlay types based on individual cases, while advancements in dental materials and restorative technology continue to expand their clinical applications.