Resin bonded bridges.modi /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Resin bonded bridges.modi /certified fixed orthodontic courses by Indian dental academy

  1. 1. Resin Bonded Fixed Partial Denture –case reports. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com 1
  2. 2. Introduction • The need for conservation of natural tooth structure has always been the desired but elusive goal in dentistry. • In fixed partial prosthodontics this goal manifests itself with the continued interest and development of Resin bonded fixed partial dentures (RBFPD). www.indiandentalacademy.com 2
  3. 3. Definition • Resin bonded prosthesis A prosthesis that is luted to tooth structure,primarily enamel,which has been etched to provide mechanical retention for the resin cement. -GPT-7 • Also called as Maryland bridges, Rochette bridges. www.indiandentalacademy.com 3
  4. 4. Why a Re-Look ? 1. Sometimes Cost and other constraints make single teeth implants unfeasible. 2. Recent and further scope of Advances in adhesive dentistry. 3. Lesser failure rates of RBFPD’s found in recent studies. www.indiandentalacademy.com 4
  5. 5. History and development • Development of Acid etching of enamel by Buonocore. • Bowen developed the BIS-GMA composite resins. www.indiandentalacademy.com 5
  6. 6. Rochette bridge • Developed in 1973. It was a complete innovation. Use of ring like retainers,with funnel shaped perforations through them to enhance resin retention. Silane coupling agent was used to produce adhesion to the metal. www.indiandentalacademy.com 6
  7. 7. Maryland ridge • Etched metal surface first developed by Livaditis and Thompson. • Treatment of metal surface with acids and controlled electric current. www.indiandentalacademy.com 7
  8. 8. Virginia bridge. • Roughned surface of the retainer itself provides for retention • Achieved by lost salt technique. • Air abrasion with aluminium oxide. www.indiandentalacademy.com 8
  9. 9. Advantages of Resin bonded bridges. 1) 2) 3) 4) 5) Reduced cost . No anesthetic needed. Supragingival margins. Minimal tooth preparation. Rebonding possible. www.indiandentalacademy.com 9
  10. 10. Indications. 1) Adolescents with single missing teeth (traumatic or congenital). 2) Caries- free abutment teeth and good oral hygiene. 3) Maxillary incisor replacements (most favourble prognosis) and Mandibular incisor replacements. 4) Periodontal splints. 5) Single posterior tooth replacements. www.indiandentalacademy.com 10
  11. 11. • Survival rates of FPD – 96% at 5 years – 74% at 15 years • Creugers et al 1994. • Survival rates of RBFPD – 74% at 4 years (meta study) – 93% at 11 years Barrack www.indiandentalacademy.com 11
  12. 12. Tooth preparation  The strength of bonding to prepared and etched enamel is greater than that to etched but unprepared enamel.(Aker et al 1979)  Preparation should cover as large as area as esthetically possible www.indiandentalacademy.com 12
  13. 13. Cervical margin should always be in enamel and Supragingival. Preparation should ensure precise insertion and seating of the framework. 180 0 wraparound of the metal. www.indiandentalacademy.com 13
  14. 14. Case-1 • History www.indiandentalacademy.com 14
  15. 15. Examination • Root exposure of central incisor and canine. • Widened edentulous space mesiodistally. • I mm over jet and overbite www.indiandentalacademy.com 15
  16. 16. • Good oral hygiene and favorable periodontal status. • Study models were made and articulated. • Radiographs were taken. www.indiandentalacademy.com 16
  17. 17. Treatment plan • Resin bonded fixed partial denture was the treatment of choice 1. As it kept the option of going for bone grafting and implant a possibility. 2. Angulation of abutments and gingival recession made the possibility of 3 unit conventional FPD a difficult proposition. www.indiandentalacademy.com 17
  18. 18. Tooth preparation • Very conservative palatal preparation. • Supragingival chamfer. • Proximal groves. www.indiandentalacademy.com 18
  19. 19. Laboratory procedure • Wax pattern was made and casted in Ni-Cr alloy. • Pontic was made in appropriate shade of ceramic. • Holes were made on the wings to facilitate light curing of composite. www.indiandentalacademy.com 19
  20. 20. Bonding steps. • Sand blasting of metal framework. • Acid etching • Rinsing and drying. • Contamination to be avoided at all cost. www.indiandentalacademy.com 20
  21. 21. www.indiandentalacademy.com 21
  22. 22. www.indiandentalacademy.com 22
  23. 23. www.indiandentalacademy.com 23
  24. 24. www.indiandentalacademy.com 24
  25. 25. www.indiandentalacademy.com 25
  26. 26. www.indiandentalacademy.com 26
  27. 27. Case 2 • Missing mandibular Right central incisor www.indiandentalacademy.com 27
  28. 28. • Bone loss and gingival recession in abutment teeth. • Grade 1 mobility. www.indiandentalacademy.com 28
  29. 29. Treatment plan. • Resin bonded fixed partial denture was the treatment of choice. As patient wanted a fixed replacement of the missing teeth. Need for splinting the lower anteriors. www.indiandentalacademy.com 29
  30. 30. Tooth preparation www.indiandentalacademy.com 30
  31. 31. • Conventional Maryland bridge fabricated with porcelain fused to metal pontic. www.indiandentalacademy.com 31
  32. 32. • Bonded with resin cement. www.indiandentalacademy.com 32
  33. 33. www.indiandentalacademy.com 33
  34. 34. www.indiandentalacademy.com 34
  35. 35. Case 3 • 16 year old female patient. • Traumatic loss of maxillary left central incisors . • Using RPD for 3 years. www.indiandentalacademy.com 35
  36. 36. • Ridge resorption. • Widened pontic space. www.indiandentalacademy.com 36
  37. 37. Treatment plan Resin bonded bridge was the treatment of choice. • Taking into consideration age of the patient. • Need for the conservative treatment. www.indiandentalacademy.com 37
  38. 38. www.indiandentalacademy.com 38
  39. 39. Case –4 Metal free resin bonded bridge • Loss due to trauma. • Highly reduced pontic space. www.indiandentalacademy.com 39
  40. 40. Treatment plan. Metal free resin bonded bridge was the treatment of choice • As patient had edge to edge bite - less unfavourable stresses transmitted to the prosthesis. • Superior esthetics. www.indiandentalacademy.com 40
  41. 41. Treatment plan • Proximal slicing of the abutments was done to distribute the space evenly. • Diagnostic wax up was shown to the patient www.indiandentalacademy.com 41
  42. 42. www.indiandentalacademy.com 42
  43. 43. Temporization www.indiandentalacademy.com 43
  44. 44. Laboratory procedures • Hardcore porcelain fired on refractory cast.(Hi – ceram) • Porcealin build up done on the coping . www.indiandentalacademy.com 44
  45. 45. www.indiandentalacademy.com 45
  46. 46. www.indiandentalacademy.com 46
  47. 47. www.indiandentalacademy.com 47
  48. 48. www.indiandentalacademy.com 48
  49. 49. Disadvantages • • • • • Irreversible. Uncertain longevity. No space correction. No alignment correction. Difficult temporization. www.indiandentalacademy.com 49
  50. 50. Contraindications. • • • • Extensive caries. Nickel sensitivity. Deep vertical overbite. Extensive restoration on abutment teeth. • Parafuncitonal habits www.indiandentalacademy.com 50
  51. 51. Conclusion • Rapid development in adhesive technology holds a promising future for RBFPDs, which were originally developed as an interim restoration. Today high success rate and reducing cost is fast making RBFPD’s as a treatment alternative for permanent oral rehabilitation. www.indiandentalacademy.com 51
  52. 52. • Furthermore in a developing country like India this esthetic approach, which is cost effective too, holds promising future. www.indiandentalacademy.com 52
  53. 53. www.indiandentalacademy.com 53

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