Inlays, Onlays, vs. Crowns: Choosing the Best Restoration for Your Tooth

Last updated on May 7th, 2025

When a tooth is damaged by decay or injury, restoring its shape, function, and strength is crucial for your oral health. But with options like inlays, onlays, and crowns, how do you know which treatment is best?

Tooth cavities are a common dental problem, and dental fillings are usually the most immediate treatment choice, especially in the early stages. However, if the decays are larger, filling may not work as desired. Thus, dentists tend to apply inlays and onlays or crowns. Both patients and dental professionals have to come to a point where they need to compare the benefits of Inlays and Onlays vs. Crowns. Not surprisingly, dental professionals have a vast wealth of experience and expertise, and thus, they are more capable of determining the pros and cons of each choice for a patient. Alas, patients normally lack the knowledge and understanding of those potential treatment options.

In this post, we will explain many details about Inlays and Onlays vs. Crowns to give you a broader understanding of each treatment by contrasting them using clear explanations, tables, and examples. 

What Are Inlays, Onlays, and Crowns?

These are all types of indirect restorations, meaning they are custom-made outside your mouth (usually in a dental lab or using in-office technology) and then bonded to your tooth. They differ primarily in the amount of tooth structure they replace.

Dental Inlays

• What they are: An inlay fits within the contours of the tooth’s chewing surface, similar to a filling, but it’s fabricated as a single, solid piece.
• When they’re used: Ideal for repairing decay or damage that is contained within the cusps (the bumps on the chewing surface) of the tooth. It’s a good option when decay is too large for a simple filling but doesn’t affect the outer cusps.
• Materials: Commonly made from tooth-colored porcelain (ceramic) or composite resin for aesthetics, or sometimes gold for exceptional durability.

Dental Onlays

• What they are: An onlay is more extensive than an inlay. It covers one or more of the tooth’s cusps and can extend over the chewing surface. Sometimes called a “partial crown.”
• When they’re used: Suitable when decay or damage involves one or more cusps, but doesn’t require covering the entire tooth like a crown. They provide more support than an inlay for moderately damaged teeth.
• Materials: Similar to inlays – porcelain, composite resin, or gold.

Dental Crowns

• What they are: A crown (or “cap”) covers the entire visible portion of the tooth above the gumline.
• When they’re used: Necessary when a tooth has extensive decay, a large fracture, has undergone root canal therapy, or needs significant structural support. They provide the most comprehensive protection for severely weakened teeth.
• Materials: Can be made from full porcelain crown, ceramic (like E-max or zirconia), porcelain-fused-to-metal (PFM), or metal alloys (like gold). Material choice depends on strength requirements, aesthetics, and location in the mouth. 

For a visual overview, watch this informative video where Dr. Volkan Yigit Seymen from Maltepe Dental Clinic explains the key differences between inlays, onlays, and crowns, highlighting material options and when each restoration is typically used.

Comparing Your Options: Inlay vs. Onlay vs. Crown

Choosing the right restoration depends on the specific condition of your tooth. Here’s a quick comparison:

Feature	Inlay	Onlay	Crown
Primary Goal	Repairing decay within tooth cusps	Repairing decay/damage, including tooth cusps	Full tooth coverage and protection
Tooth Preservation	High (Conservative)	Medium-High (More conservative than crown)	Lower (Requires more tooth reduction)
Typical Indication	Moderate decay, confined center	Larger decay/fracture involving cusps	Severe decay/fracture, root canal treated tooth
Common Materials	Porcelain, Composite, Gold	Porcelain, Composite, Gold	Porcelain, Ceramic, Zirconia, PFM, Gold
Reported Longevity*	Good to Excellent	Good to Excellent	Generally Excellent
Aesthetics	Excellent (with tooth-colored material)	Excellent (with tooth-colored material)	Excellent (with modern ceramics)
Procedure Complexity	Usually 2 visits	Usually 2 visits	Usually 2 visits (can require more prep)
Relative Cost**	253€	253€	298€

*Longevity depends heavily on material choice, dentist’s skill, patient’s oral hygiene, bite forces, and regular dental check-ups. Recent studies¹ and systematic reviews² suggest high survival rates for well-placed modern restorations. For example, meta-analyses³ indicate 5-year survival rates around 91% for composite inlays/onlays/overlays and 10-year survival rates around 85% for ceramic versions.
** For detailed pricing, please check our price list

Key Considerations & Latest Insights

• Preserving Tooth Structure: A major advantage of inlays and onlays, highlighted in recent dental literature⁴, is their ability to preserve more of your natural tooth compared to crowns. This conservative approach can be beneficial for the long-term health of the tooth.
• Durability & Strength: While crowns offer maximum coverage, modern materials for inlays and onlays (especially ceramics and reinforced composites) provide excellent durability and can effectively strengthen the remaining tooth structure. Research⁵ shows they perform very well long-term when indicated and placed properly.
• Aesthetics: Tooth-colored materials for all three restoration types allow for highly aesthetic results that blend seamlessly with your natural smile, a key aspect of modern cosmetic dentistry.

How to Choose the Right Restoration for You?

The best choice isn’t always obvious and depends entirely on your individual situation. During your examination, your dentist will assess several factors:

• Extent of Damage: How much healthy tooth structure remains?
• Location of Tooth: Molars experience higher chewing forces than front teeth.
• Bite and Chewing Habits: Factors like grinding (bruxism) might influence material choice.
• Aesthetic Goals: How important is the appearance of the restoration?
• Budget: Costs vary between the different procedures and materials. For instance, composite inlays and onlays can be a durable and affordable tooth-colored choice. 

If an inlay or onlay is being considered, understanding the benefits and procedure involved can help inform your decision.

If a crown is the recommended treatment, our guide on choosing the right dental crown can provide further insights.

How to Care for Your Inlays, Onlays, Or Crowns

Once your tooth is restored with an inlay, onlay, or crown, proper care is essential to ensure its longevity and maintain your overall oral health. Thankfully, caring for these restorations is very similar to caring for your natural teeth:

1. Maintain Excellent Oral Hygiene:
   • Brushing: Brush your teeth thoroughly twice a day for at least two minutes using a fluoride toothpaste and a soft-bristled toothbrush. Pay gentle attention to the area where the restoration meets your natural tooth (the margin).
   • Flossing: Floss daily to remove plaque and food particles from between your teeth, including around the restored tooth. Gently slide the floss up and down, being careful not to snap it against the restoration’s edge.
2. Be Mindful of Your Diet:
   • While inlays, onlays, and crowns are strong, avoid chewing extremely hard foods (like ice, hard candies, or nut shells) or very sticky foods directly on the restored tooth, as this could potentially cause damage or dislodgement over time.
3. Avoid Harmful Habits:
   • Refrain from using your teeth as tools (e.g., opening packages, biting fingernails).
   • If you grind or clench your teeth (bruxism), especially at night, discuss this with your dentist. They may recommend a custom nightguard to protect your restoration and natural teeth from excessive forces.
4. Attend Regular Dental Check-ups:
   • Visit your dentist regularly for professional cleanings and examinations (typically every six months or as recommended by your dentist). These appointments allow us to monitor the condition of your restoration, check its margins, and ensure the surrounding teeth and gums remain healthy. Early detection of any potential issues is key to long-term success.

By following these simple steps, you can help your inlay, onlay, or crown function beautifully and protect your smile for many years to come.

A Patient’s Experience at Maltepe Dental Clinic

Hearing from patients who have undergone treatment can be incredibly helpful. Watch Imani share her transformative journey with crowns and veneers at our clinic, discussing her initial thoughts, the process, and the positive impact on her life and confidence.

Trust Your Smile Restoration to Maltepe Dental Clinic

Choosing the right dental restoration is an important step towards a healthy, functional smile. Our team at Maltepe Dental Clinic combines years of experience with a commitment to using modern techniques and materials to achieve outstanding, long-lasting results.

Ready to discuss your options? Schedule a consultation today!

SOURCES

1. Fan J, Xu Y, Si L, Li X, Fu B, Hannig M. Long-term Clinical Performance of Composite Resin or Ceramic Inlays, Onlays, and Overlays: A Systematic Review and Meta-analysis. Oper Dent. 2021 Jan 1;46(1):25-44. doi: 10.2341/19-107-LIT. PMID: 33882133. ↩︎
2. Morimoto S, Rebello de Sampaio FB, Braga MM, Sesma N, Özcan M. Survival Rate of Resin and Ceramic Inlays, Onlays, and Overlays: A Systematic Review and Meta-analysis. J Dent Res. 2016 Aug;95(9):985-94. doi: 10.1177/0022034516652848. Epub 2016 Jun 10. PMID: 27287305. ↩︎
3. https://pubmed.ncbi.nlm.nih.gov/33882133/ ↩︎
4. Wang B, Fan J, Wang L, Xu B, Wang L, Chai L. Onlays/partial crowns versus full crowns in restoring posterior teeth: a systematic review and meta-analysis. Head Face Med. 2022 Nov 21;18(1):36. doi: 10.1186/s13005-022-00337-y. PMID: 36411462; PMCID: PMC9677648.
   
   Hopp CD, Land MF. Considerations for ceramic inlays in posterior teeth: a review. Clin Cosmet Investig Dent. 2013 Apr 18;5:21-32. doi: 10.2147/CCIDE.S42016. PMID: 23750101; PMCID: PMC3666490. ↩︎
5. Bustamante-Hernández, N., Montiel-Company, J. M., Bellot-Arcís, C., Mañes-Ferrer, J. F., Solá-Ruíz, M. F., Agustín-Panadero, R., & Fernández-Estevan, L. (2020). Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 17(20), 7582. https://doi.org/10.3390/ijerph17207582
   
   Fan J, Xu Y, Si L, Li X, Fu B, Hannig M. Long-term Clinical Performance of Composite Resin or Ceramic Inlays, Onlays, and Overlays: A Systematic Review and Meta-analysis. Oper Dent. 2021 Jan 1;46(1):25-44. doi: 10.2341/19-107-LIT. PMID: 33882133. ↩︎