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Dentists frequently recommend inlays or onlays to restore damage to the chewing surfaces of back teeth. Both inlays and onlays are pre-formed from a mold so they'll fit your tooth precisely. But what's the difference between the two?
Inlays fit within the grooves between the cusps of your tooth. Onlays fit within the grooves and wrap up and over the cusp tips, so they cover more of the tooth's surface. Your dentist will decide which is most appropriate for you, based on the amount of tooth structure lost to wear or decay.
The procedure
Restoring a tooth with inlays or onlays takes two or more appointments to accomplish, since they are fabricated in a lab for a custom fit to your teeth.
During the first appointment, your dentist will carefully remove the part of your tooth that is damaged and then shape the remaining portion of the tooth so that it can hold the inlay or onlay.
At this point, an impression will be made of the damaged tooth and the teeth that surround it, as well as your bite, using a soft, clay-like substance. Dental lab technicians then build a model on the impression; this model is an exact duplicate of that particular part of your mouth. The inlay or onlay is then created on that model.
At the next visit, the inlay or onlay is placed on your tooth and is adjusted for a precise fit. Once that's achieved, the restoration will be cemented permanently onto your tooth. It then will be polished, and your bite will be checked to ensure a perfect fit.
What material is used?
The teeth in the back of your mouth are used primarily for chewing, so it's vital that the material used for inlays and onlays be strong enough to withstand frequent pressure. Your dentist will likely use alloy, a mixture of metals such as gold, palladium, nickel or chromium, if the tooth remains unseen when you smile. If the restoration is closer to the front of your mouth, so it shows when you smile, she will probably recommend that a tooth-colored ceramic be used. Ultimately, that choice will be yours.
Working with your dentist, you can restore decayed, damaged or worn teeth to near-perfect condition with inlays or onlays.
Source - The American Dental Association