Ceramic Overlay for the Cuspal Coverage

Performed by: Dr Naveed Anjum


Tooth no 36 presented with mesial chipping that was restored with Direct Composite filling before. Patient got that filling done 1 year before for the second time . He is looking for some treatment will last long enough. The old restoration was already wide and involving more than 2/3 of all cusps, so cusps coverage was planned. The treatment options considered were direct composite cusp coverage, Indirect ceramic overlay and full coverage crown.  After discussing with patient about the mechanic properties, invasiveness, cost and long term outcome , Indirect ceramic overlay was selected.

Wedgeguard were placed to avoid the iatrogenic damage to adjacent teeth. Approximal reduction done after the approval reduction. Shoulder margins are created for the Lithium Disilicate  Over Lay. Final impression taken with Addition Silicone with one step technique.Trail was done to check the dry Fit before the isolation. After this the tooth is isolated with Rubber dam and cleaned with micrabrasion and selective etching done with 37 % phosphoric acid. Intaglio surface of overlay is prepared with HF 10 % etching.

Rely X veneer Cement Kitt is used for the Bonding by selecting A2 shade.  Excess cement is removed with floss and Bonding Brush.
Occlusion is checked and adjusted with articulating paper both in centric and eccentric position.


#1 Pre OP condition Mirror view


#2 Pre OP condition Buccal Direct view


#3 Wedge guards placed to avoid iatrogenic damage to adjacent teeth

#4 Gingival Floor is finished after placing the wooden Wedges so the bur can Run smooth in that area

#5 Final Preparation


#6  Temporary restoration given with flowable composite by spot etch without Bond


#7 Ready Restoration

#8 Tooth is isolated with inverted dam at all the margins


#9 Once again the Trial is done to check the fit


#10 Dry Fit


#11 Sand Blast and Etch


#12 Healthy enamel


#13 Bonded


#14  Buccal view


#15 Lingual view


#16 Rubber Dam is removed                                                            #17 Baccal View


#18 Lingual view                                                                              #19 Occlusion


#20 Checked with articulating paper                                          #21 Post Operative X ray



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