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Resin Bonded Bridges mary land bridge.ppt
- 2. Introduction One of the disadvantages of a conventional fixed partial denture with either full veneer or partial veneer crown retainers is the destruction of tooth structure required for the abutment preparations. Various solutions for this problem have been tried through the years, which are: Inlay retainers Unilateral removable partial dentures A cantilever fixed partial denture
- 3. Resin –retained FPD have had variable popularity since the technique of splinting lower anteriors with perforated metal casting was described by Rochette in 1973. As an alternative to conventional metal –ceramic FPD’s. The development of acid etching of enamel to improve the retention of resin, first described by Buonocore in 1955 . Means of attaching fixed partial dentures to teeth by less destructive means.
- 4. Ibsen first described the attachment of an acrylic resin pontic to an unprepared tooth using a composite bonding resin. The advent of electrolytic etching of metal to provide micromechanical retention for metal adhesion to enamel has led to the broad application of such bridges.
- 5. HISTORY- DEVELOPMENT OF RBP Bonded pontics Cast perforated resin – retained FPD’s(Mechanical retention) Etched cast resin – retained FPD’s (Micromechanical retention MARYLAND BRIDGE) Macroscopic Mechanical retention resin – retained FPD’s (VIRGINIA BRIDGE) Chemical Bonding Resin- Retained FPD’s (ADHESION BRIDGES)
- 9. DESIGN CONCEPTS The underlying principle for these restorations has always been that it is necessary to cover as much enamel surface as possible, as long as occlusion, esthetics, or periodontal health are not compromised
- 10. General Principles of Design Creation of a distinct path of insertion for the restoration by a sequence of modifications to the enamel contours of the abutment teeth. The restoration should not be displaced or rocked in any direction by occlusal forces. The bonding of the alloy to the tooth structure allows the casting to be supported by the tooth structure.
- 11. Posterior design principles A distinct path of A distinct path of insertion must be insertion must be created in an created in an occlusogingival occlusogingival direction. direction.
- 12. Proximal resistance form must be created. i.e. extend buccally beyond the distobuccal and mesiobuccal line angles of the respective abutments. Maximum bonding area obtained with the proximal and lingual modifications, which lower the height of contour.
- 13. Proximal Proximal "wrap-around" "wrap-around" should be should be obtained obtained.
- 14. Some form of occlusal rest is Some form of occlusal rest is required on each abutment of a required on each abutment of a posterior resin-bonded restoration posterior resin-bonded restoration
- 15. Create knife-edge gingival margins on posterior abutment teeth with supragingival margin.
- 16. Anterior Design Principles The same general principles for retention as does the posterior retainer. The modifications made to the enamel of abutment teeth are much more subtle than those used in the posterior region.
- 17. A distinct path of insertion Extension of the framework over the marginal ridge not involved with the edentulous space as well as over the marginal ridge lingual to the connector. Modification of each abutment to create a distinct cingulum notch.
- 20. Advatages Minimal Tooth Preparation Minimal potential for pulpal trauma No Anesthetic Needed Supragingival Margins Easy impression making Provisional not usually required Reduced chair time Unaltered casts without removable dies Reduced Cost Rebonding Possible
- 21. DISADVANTAGES Irreversible Uncertain Longevity Enamel modification is required No Space Correction Good Alignment of abutment is required Plaque accumulation can occur Difficult Temporization Patients expectation of esthetics is high Graying out of teeth Dependence on laboratory Esthetics is compromised on posterior teeth
- 22. INDICATIONS Replacement of missing anterior teeth in children and adolescents Caries-free Abutment Teeth/ Unrestored abutments Mandibular Incisor Replacements Maxillary Incisor Replacements Periodontal Splints Stabilizing dentition after orthodontics Prolonged placement of interim prosthesis Single Posterior Tooth Replacements Significant clinical crown length
- 23. CONTRAINDICATIONS Parafunctional habits Long edentulous span Extensive Caries Restored or damaged abutments Compromised enamel Significant pontic width discrepancy Nickel Sensitivity Deep Vertical Overbite Incisors with thin faciolingual dimension
- 28. Bonding the restoration Resin cements PANAVIA 21 Rely X Biscore