Everything about molar cavity treatment – E-max ceramic inlay

summary: We show you how to treat molar tooth decay with Emax ceramic onlay and resin.

Today we show you the usual molar tooth decay treatment.

We will show you the most recommended E-max inlay onlay and composite resin filling for molar tooth decay treatment.

Start from the pre-treatment pictures.

초진 파노라마

Start from the pre-treatment pictures.

It’s hard to find a big problem on the dental x-ray right now. At least on radiographs, cavities are not large or deep.This patient has not been treated with dental treatment since the end of treatment about 10 years ago.This patient has received some amalgam treatment and resin treatment.

Let’s take a look at the patient’s mouth divided into four parts – right lower, left lower, right upper and left upper.

Start from right lower molar

하악우측대구치 충치
Lower right first molar tooth

We’ll not treat the secondary caries of the second molar with resin filling. Instead, it should be monitored carefully and checked up regularly.

The first molar, whose surface is destroyed and appears to have the fast rate of cavity, decides to get  E-max onray treatment.

The lower leftmolar.

하악좌측대구치 아말감2차충치
Both amalgamated teeth and the teeth behind it must be serious case if they are decontaminated.

Both the lower left teeth need to be treated.

The upper right tooth

상악대구치 작아보이는 충치
Looking small? I bet deep cavity in upper right molar.

The cavities in the maxillary right molar appear to be small. However, if you remove the small cavities, it is often connected to the inside and becomes bigger.

First of all, we create a treatment plan with composite resin filling. Notice that we can change the plan to Inlay if necessary.

레진 접착

Amazing resin adhesion

Advantages of dental resin

For the pros and cons of treating cavities, refer to the above link.  The biggest advantage of direct resin filling is minimal invasive treatment among all of them.

The upper left tooth

상악대구치 작아보이는 충치
상악대구치 작아보이는 충치

The Maxillary left  first molar (black dotted tooth) is planned to get a resin filling treatment.

To summarize the treatment plan, every treatment will be done according to an emergency level.

Lower molar teeth are treated with E-max, while upper molar teeth are treated with direct composite resin filling.

Let’s get started.

Right lower molar

하악대구치 충치 제거중
하악대구치 충치

We remove not only the occlusal cavity, but also the buccal small cavities.

하악대구치 삭제,인상채득후
Small buccal cavities will be filled with resin separately

After removing the cavity, we fill flowable resin base resin not only to make the floor flat but also protects the tooth pulp damage.

이맥스 인레이 세팅후

E-max onlay is seated and cemented. (Note lower molar teeth are close to tongue and easy to get wet, which makes proper cementation is hard to get.)

이맥스 인레이 세팅후

Removing cement residue and polishing the surface.
It looks great.

We go to the lower left molar.

좌측하악대구치 치료전

All of the molars (1st, 2nd and the 3rd molar) are decayed. Wisdom tooth would be extracted, not treated in this case.

하악제2대구치 충치제거중

Removing the cavity with a speedy and large deletion tool to determine its appearance, you can see deeper black cavities.

하악제2대구치 충치제거중

Remove the black cavities one by one. Careful care should be taken not to get a root canal treatment.

하악1대구치 아말감

Is the amalgam tooth that the patient once received a treatment clean? Is it available to use this amalgam longer than this?

하악 1 2대구치 충치 제거

It is not clean.
Furthermore, unlike the lower left molar, the right molar amalgam area is not so small in the buccal(cheek) area.
We must remove all of the affected areas and should extend the cavity boundary to onlay, not the inlay.

하악2대구치 충치제거

But the problem is that the second molar tooth that I have not yet cured, is the deep, deep deep tooth cavity.

하악2대구치 깊은 충치

The cavities are so serious that my heart is troubled.

First of all, I apply MTA to avoid root canal treatment if possible.

MTA resin cure

Should I get root canal treatment and tooth crown?

Whatever MTA is, all cavities should be removed thoroughly.

하악1대구치 충치제거

After removing all decay lesion, I took a commemorative photo 😛 .
Removing all cavity extends the outline of ‘prep’ to the cheek and buccal side. Fill the resin core to level the floor.

하악대구치 삭제후 인상채득

Impression is taken.

하악대구치 이맥스 인레이 세팅

Cement the E-max onlay. Some resin cement remains a little messy, so it’s removed.

하악대구치 이맥스 인레이 세팅

Adjust the bite height (occlusion) and polish the surface. It becomes so clean.

Start treatment for the upper right tooth.

상악대구치 충치

The second tooth from the end, the second molar. (Middle teeth in this pic)

상악대구치 충치

If we blow it off and look at it in the mirror, we see my goal.

Going to get rid of all these dirty holes !!

상악대구치 충치 제거중
I'm the core of cavity LOL!

Bigger than I thought. I thought it was a mole, so I only tried to dig it out.

상악대구치 충치 제거중
상악대구치 충치제거

I have scraped it all the way to the big cavity in the inside

상악대구치 레진충전중

Incremental placement

Overcome the polymerization shrinkage of resin

Start incremental composite resin filling,

상악대구치 레진충전

Looks good?Well done

(In fact, it is stacked more than 5 times, not 1 time.)

상악대구치 충치

Cavities are easily formed in this concave area called groove.

상악대구치 충치

Remove the largest part first.

상악대구치 충치

I do not think cavities will be deep though, this treatment removes all cavities in the teeth.

상악대구치 충치

Removed cavities enough.

It’s time for incremental composite resin placement.

상악대구치 충치 레진충전중

It looks green since it is under green color light, which protect unnecessary light curing.

상악대구치 충치 레진충전중

Start from the deepest , the most dangerous cavity floor. We should not to make any air bubble inside this composite resin.

상악대구치 충치 레진충전중

Carefully fill and build composite resin  to minimize the polymerization shrinkage, even though it takes a lot of time

상악대구치 충치 레진충전중

Building the original shape so that the occlusal surface does not become flat.

상악대구치 충치 레진충전중

In the green light, it is difficult to check the shape of the teeth.

Look at where the shape is lacking and add resin.

상악대구치 충치 레진충전

I did it, but it seems to be so good (……..)

To summarize, the large range of cavities in lower molar teeth were treated with E-max onlay.

the middle one is before treatment, while the front and the end is after-treatment

While the small looking cavities (yeah, it WAS bigger and deeper than I guess) were treated with composite resin filling.

the middle one is before treatment, while the front and the end is after-treatment

The treatment methods and materials are based on the size and location of the tooth cavity. According to these,  Dr.Jeung will suggest the proper options.
Of course, I would also consider the economic situation of the patient.
If it’s not possible to get all treatments needed, I would rather tell you from the urgent treatment of the fast pace.

Prices of this dental clinic would not be cheap at all.

All treatment is done by the dentist not by non-professional staffs. No necessary intermediate steps are skipped. That’s my pride in this dental clinic.

This is Dr.Jeung, the chief dentist of SEOULDEN Dental Clinic.

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