Podcast
Questions and Answers
What is the recommended distance from the incisal or occlusal edge for the margins of a resin-bonded FDP?
What is the recommended distance from the incisal or occlusal edge for the margins of a resin-bonded FDP?
What is the purpose of making definitive rests and grooves in a resin-bonded FDP?
What is the purpose of making definitive rests and grooves in a resin-bonded FDP?
What percentage of the tooth circumference should be prepared for a resin-bonded FDP?
What percentage of the tooth circumference should be prepared for a resin-bonded FDP?
What is the purpose of making an accurate impression in a resin-bonded FDP?
What is the purpose of making an accurate impression in a resin-bonded FDP?
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Why are temporary occlusal stops important in a resin-bonded FDP?
Why are temporary occlusal stops important in a resin-bonded FDP?
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What is the recommended tool for preparing occlusal rest seats and cingulum notches in a resin-bonded FDP?
What is the recommended tool for preparing occlusal rest seats and cingulum notches in a resin-bonded FDP?
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What is the recommended tool for preparing gingival margins and circumferential preparation in a resin-bonded FDP?
What is the recommended tool for preparing gingival margins and circumferential preparation in a resin-bonded FDP?
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Why is it important to have small, defined gingival margins in a resin-bonded FDP?
Why is it important to have small, defined gingival margins in a resin-bonded FDP?
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Why are patient satisfaction with the final result likely to be low if expectations are unrealistic?
Why are patient satisfaction with the final result likely to be low if expectations are unrealistic?
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Which of the following should be avoided when selecting abutment teeth?
Which of the following should be avoided when selecting abutment teeth?
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What is a crucial factor in assessing periodontal support when selecting abutment teeth?
What is a crucial factor in assessing periodontal support when selecting abutment teeth?
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Why may the surface area of abutment teeth be compromised?
Why may the surface area of abutment teeth be compromised?
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What type of teeth can make particularly good abutments?
What type of teeth can make particularly good abutments?
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Why may the roots of retained deciduous teeth be suitable for abutments?
Why may the roots of retained deciduous teeth be suitable for abutments?
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What is crucial to optimise success when planning for RBBs?
What is crucial to optimise success when planning for RBBs?
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What may affect the degree to which a retainer can be extended?
What may affect the degree to which a retainer can be extended?
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What is the primary goal of restoring missing teeth?
What is the primary goal of restoring missing teeth?
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In which patients may accepting a shortened dental arch be a suitable option?
In which patients may accepting a shortened dental arch be a suitable option?
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Why may RBBs be preferable to RPDs in certain patients?
Why may RBBs be preferable to RPDs in certain patients?
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What is a disadvantage of RBBs for young patients who have suffered the early loss of an anterior tooth?
What is a disadvantage of RBBs for young patients who have suffered the early loss of an anterior tooth?
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What should be considered when managing patient expectations with regard to RBBs?
What should be considered when managing patient expectations with regard to RBBs?
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Why may RBBs be a suitable option for patients who are apprehensive of dental treatment?
Why may RBBs be a suitable option for patients who are apprehensive of dental treatment?
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What is essential for patients before embarking on fixed prosthodontics with RBBs?
What is essential for patients before embarking on fixed prosthodontics with RBBs?
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What is a characteristic of the preparation for RBBs?
What is a characteristic of the preparation for RBBs?
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What is unique about the posterior splint-FDP?
What is unique about the posterior splint-FDP?
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What is the purpose of surface treatment for bonding in RBB?
What is the purpose of surface treatment for bonding in RBB?
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What is a characteristic of the Cast perforated resin-bonded bridge (Rochette bridge)?
What is a characteristic of the Cast perforated resin-bonded bridge (Rochette bridge)?
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What is the function of salt crystals in the Virginia bridge?
What is the function of salt crystals in the Virginia bridge?
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What is a limitation of the Cast mesh pattern (dura lingual)?
What is a limitation of the Cast mesh pattern (dura lingual)?
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What is a characteristic of anterior splint design?
What is a characteristic of anterior splint design?
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What is the advantage of fiber-reinforced RBB?
What is the advantage of fiber-reinforced RBB?
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What is the purpose of macro-mechanical retention?
What is the purpose of macro-mechanical retention?
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What is a disadvantage of using composite resin pontics?
What is a disadvantage of using composite resin pontics?
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What is the primary advantage of using unidirectional fibres in a composite?
What is the primary advantage of using unidirectional fibres in a composite?
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What is the purpose of oral health education in resin-bonded bridges?
What is the purpose of oral health education in resin-bonded bridges?
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What is the most common technical reason for RBB failure?
What is the most common technical reason for RBB failure?
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What type of fibre arrangement is most suitable for constructing long spans?
What type of fibre arrangement is most suitable for constructing long spans?
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What is the primary advantage of using bidirectional fibres in a composite?
What is the primary advantage of using bidirectional fibres in a composite?
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What should patients be warned of when a fixed-fixed design has been used?
What should patients be warned of when a fixed-fixed design has been used?
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What is the primary advantage of using composite resin?
What is the primary advantage of using composite resin?
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Study Notes
Resin Bonded Bridges
- Definition: A single pontic supported by a thin metal retainer placed lingually and proximally on the abutment teeth, with minimal preparation limited to enamel and labial surface remaining intact.
Case Selection
- Patient factors to consider:
- Health and age of the patient
- Patient expectations
- Local factors related to dental health and the missing tooth itself
- Accepting a shortened dental arch in older patients with reduced manual dexterity
- Preferable to a removable partial denture (RPD) in cases with significant periodontal disease or dental caries
- Advantageous for young patients who have suffered early loss of an anterior tooth
- Minimally invasive, requiring minimal clinical time and rarely needing anaesthetic
- Suitable for patients who are apprehensive of dental treatment or unable to commit to more involved treatment
- Importance of managing expectations regarding aesthetic outcome and longevity
Abutment Tooth Selection
- Investigations should be carried out to ensure endodontic and periodontal health
- Periodontal support should be assessed considering bone levels and root configuration
- Abutments with active periodontal disease should be avoided
- Coronally, sufficient enamel should be available for bonding
- Surface area may be compromised if teeth are restored or have significant tooth wear
- Alignment or angulation of teeth may affect the degree to which a retainer can be extended
- Unconventional approaches may be necessary in certain cases
- Deciduous teeth can make good abutments due to their multirooted nature and large coronal surface area
Occlusal Features
- Detailed assessment of both static and dynamic occlusal relationships is crucial for optimal success
- Gingival margins and circumferential preparation can be accomplished with a chamfer or round-tipped diamond
- Occlusal rest seats and cingulum notches can be prepared with a diamond or carbide inverted cone bur
- Retentive features (e.g., slots, grooves) can be made with a tapered fissure bur
- Restoration design should be determined before beginning tooth preparation
- Importance of surveying the abutment teeth and making diagnostic preparations on a cast
Preparation and Bonding
- Step-by-step procedure:
- Leave margins about 1 mm from the incisal or occlusal edge and, if possible, 1 mm from the gingival margin
- Definite rests and grooves provide resistance form for the retainers and assist in positive seating during cementation
- Small, defined gingival margins guide the laboratory as to the gingival extent of the retainer
- Make an accurate impression, as marginal fit is crucial for a resin-bonded restoration
- Provide temporary occlusal stops to avoid supraocclusion of the abutment teeth
Bonding Materials
- Three different materials to use for RBB:
- Metal
- Ceramic
- Fiber reinforced
Surface Treatment for Bonding
- Depends on retainer material
- Surface treatment for metal RBB:
- Mechanical: Macro retention
- Cast perforated resin-bonded bridge (“Rochette bridge”)
- Water soluble salt crystals (Virginia bridge)
- Cast mesh pattern (dura lingual)
Pontic Designs
- Extracted natural teeth
- Acrylic teeth
- Bonded to proximal or lingual surface of abutment by wire or meshwork fixed by composite
- Drawback: degradation of composite and loss of pontic
- Composite resin:
- Restores esthetics and function
- Nonirritating and hygienic
- Can be repaired, modified, or removed
- Fibres can be arranged unidirectionally or bidirectionally to improve mechanical properties
Dealing with Failure
- Biological reasons for failure: caries and periodontal disease
- Technical reasons for failure: debonding
- Importance of oral health education and patient warning regarding debonding
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Description
Learn about resin bonded bridges, a type of dental restoration that aims to improve oral function, aesthetics, and occlusal stability. Understand the three phases for predictable success: case selection, preparation of abutment teeth, and bonding.
