Podcast
Questions and Answers
What is a key advantage of resin bonded retainers?
What is a key advantage of resin bonded retainers?
Which situation would not be an indication for using a resin bonded bridge?
Which situation would not be an indication for using a resin bonded bridge?
What is a common disadvantage associated with resin bonded retainers?
What is a common disadvantage associated with resin bonded retainers?
Which statement correctly describes the preparation features for resin bonded bridges?
Which statement correctly describes the preparation features for resin bonded bridges?
Signup and view all the answers
What is a major challenge during the cementation of resin bonded retainers?
What is a major challenge during the cementation of resin bonded retainers?
Signup and view all the answers
In which occlusion scenario could resin bonded bridges typically be employed?
In which occlusion scenario could resin bonded bridges typically be employed?
Signup and view all the answers
Which factor can contribute to the increased debonding rates of resin bonded retainers?
Which factor can contribute to the increased debonding rates of resin bonded retainers?
Signup and view all the answers
What is a limitation regarding the use of resin bonded bridges?
What is a limitation regarding the use of resin bonded bridges?
Signup and view all the answers
What is the range of lingual enamel thickness reduction for maxillary teeth compared to other teeth?
What is the range of lingual enamel thickness reduction for maxillary teeth compared to other teeth?
Signup and view all the answers
Which of the following is necessary for designing a posterior resin-bonded fixed partial denture?
Which of the following is necessary for designing a posterior resin-bonded fixed partial denture?
Signup and view all the answers
What is the recommended finish line type for a fixed partial denture preparation?
What is the recommended finish line type for a fixed partial denture preparation?
Signup and view all the answers
How deep should the proximal grooves be prepared to resist torquing forces?
How deep should the proximal grooves be prepared to resist torquing forces?
Signup and view all the answers
What is the appropriate axial reduction for maxillary molars?
What is the appropriate axial reduction for maxillary molars?
Signup and view all the answers
What is a characteristic of the mandibular first premolar preparation?
What is a characteristic of the mandibular first premolar preparation?
Signup and view all the answers
How far should the finish line be placed away from the gingival margin for optimal results?
How far should the finish line be placed away from the gingival margin for optimal results?
Signup and view all the answers
Which tool is recommended for preparing the proximal grooves in a dental preparation?
Which tool is recommended for preparing the proximal grooves in a dental preparation?
Signup and view all the answers
What is the main advantage of all-ceramic, resin-bonded bridges compared to metal-framed, resin-bonded bridges?
What is the main advantage of all-ceramic, resin-bonded bridges compared to metal-framed, resin-bonded bridges?
Signup and view all the answers
What is a critical factor to ensure adequate bonding surface area in occluso-gingival height?
What is a critical factor to ensure adequate bonding surface area in occluso-gingival height?
Signup and view all the answers
What disadvantage is typically associated with conventional metal-framed, resin-bonded bridges?
What disadvantage is typically associated with conventional metal-framed, resin-bonded bridges?
Signup and view all the answers
Which of the following is NOT a contraindication for resin-bonded fixed dental prostheses (FDPs)?
Which of the following is NOT a contraindication for resin-bonded fixed dental prostheses (FDPs)?
Signup and view all the answers
Which ceramic is identified as the material of choice for high strength in all-ceramic resin-bonded bridges?
Which ceramic is identified as the material of choice for high strength in all-ceramic resin-bonded bridges?
Signup and view all the answers
What is the primary role of MDP phosphate monomers in bonding to zirconia?
What is the primary role of MDP phosphate monomers in bonding to zirconia?
Signup and view all the answers
What is an important design principle for resin-bonded retainers?
What is an important design principle for resin-bonded retainers?
Signup and view all the answers
Which condition related to abutment teeth adversely affects retention due to enamel issues?
Which condition related to abutment teeth adversely affects retention due to enamel issues?
Signup and view all the answers
What technique involves etching the tooth structure with 37% phosphoric acid?
What technique involves etching the tooth structure with 37% phosphoric acid?
Signup and view all the answers
Which statement is true about silane coupling agents?
Which statement is true about silane coupling agents?
Signup and view all the answers
What feature should be included in the restoration design to ensure stability under occlusal forces?
What feature should be included in the restoration design to ensure stability under occlusal forces?
Signup and view all the answers
What surface treatment is considered un-etchable and typically involves sandblasting for zirconia?
What surface treatment is considered un-etchable and typically involves sandblasting for zirconia?
Signup and view all the answers
Which of the following factors contributes to the risk of grayness in anterior teeth restorations?
Which of the following factors contributes to the risk of grayness in anterior teeth restorations?
Signup and view all the answers
What is the main goal of the bonding phase in the fabrication of resin-bonded FDPs?
What is the main goal of the bonding phase in the fabrication of resin-bonded FDPs?
Signup and view all the answers
Which of the following is NOT a benefit of using all-ceramic materials?
Which of the following is NOT a benefit of using all-ceramic materials?
Signup and view all the answers
What should be minimized in the framework design to ensure longevity of the luting cement?
What should be minimized in the framework design to ensure longevity of the luting cement?
Signup and view all the answers
What should be done to the margins after cementing a restoration?
What should be done to the margins after cementing a restoration?
Signup and view all the answers
Which of the following factors is associated with higher debonding rates in resin bonded fixed partial dentures?
Which of the following factors is associated with higher debonding rates in resin bonded fixed partial dentures?
Signup and view all the answers
Which scenario would indicate a poor prognosis for resin bonded restorations?
Which scenario would indicate a poor prognosis for resin bonded restorations?
Signup and view all the answers
What type of alloys is preferred for resin bonded retainers?
What type of alloys is preferred for resin bonded retainers?
Signup and view all the answers
Which of the following is NOT a reason for failure of the bonding procedure in resin bonded restorations?
Which of the following is NOT a reason for failure of the bonding procedure in resin bonded restorations?
Signup and view all the answers
Which requirement is crucial regarding tooth preparation for resin bonded restorations?
Which requirement is crucial regarding tooth preparation for resin bonded restorations?
Signup and view all the answers
What is the main cause of premature failure in resin bonded fixed partial dentures concerning patient selection?
What is the main cause of premature failure in resin bonded fixed partial dentures concerning patient selection?
Signup and view all the answers
How should major occlusal adjustments be handled in relation to bonding a restoration?
How should major occlusal adjustments be handled in relation to bonding a restoration?
Signup and view all the answers
Study Notes
Resin Bonded Retainers
- Definition: Single pontic supported by thin metallic retainers placed lingually and proximally on abutment teeth.
-
Advantages:
- Conservative preparation: Confined to enamel, leaving labial surface intact.
- Tissue tolerant: Supragingival margins minimize trauma.
- Less traumatic preparation: Reduces pulpal trauma.
- Aesthetic advantages: Labial surface remains intact.
- Easy impression taking.
- Anesthesia often unnecessary.
- Provisional restorations not required.
- Re-bonding possible.
- Reduced cost.
- Reduced chair-side time.
-
Disadvantages:
- Questionable longevity: Debonding rates increase with time, influenced by preparation design, luting agent, and arch location.
- Higher dislodgement rates in posterior and mandibular areas due to occlusal forces and isolation difficulty.
- Cannot restore badly broken down teeth.
- Greyish appearance in thin, translucent teeth (with metallic retainers, not ceramic).
- No space and contour correction.
- Enamel modifications required.
- No alignment correction.
- Usually limited to single pontic (except for missing lower central incisors).
-
Indications:
- Replacement of congenitally missing teeth or teeth lost through trauma, especially in young patients.
- Replacing missing anterior teeth in children and adolescents, especially when conventional prosthesis is contraindicated due to management problems, plaque control, and large pulp size.
- Replacing one or two maxillary incisors in an open-bite, edge-to-edge occlusion.
- Short spans and open bite situations.
- Replacing a single posterior tooth.
- Significant crown length (2-3 mm occluso-gingival height) for adequate bonding surface area.
- Unrestored and caries-free abutment teeth.
- Sufficient enamel on abutment teeth for etching.
- Medically compromised and adolescent patients.
- Splinting periodontally compromised teeth.
- Stabilizing dentition after orthodontic treatment.
- Excellent moisture control.
-
Contraindications:
- Insufficient enamel (hypoplasia, demineralization).
- Very thin or translucent anterior teeth (causing grayness).
- Unaesthetic abutment teeth.
- Abutments with short clinical crowns, extensively restored or damaged teeth.
- Long edentulous spans, as they produce greater stresses on the casting and adhesive bond.
- Edentulous spaces requiring adjustment.
- Deep vertical overlap, as removing enamel from maxillary incisors for clearance might compromise retention.
- Nickel sensitivity (as most restorations are Ni-Cr).
- Space problems like diastema.
- Parafunctional habits (bruxism, deep-bite). These habits place excessive forces on the bridge, and resin-retained bridges have lower displacement resistance than conventional FDPs.
Fabrication
-
General principles of successful resin-bonded retainer design:
- Creating a distinct path of insertion by modifying enamel contours of abutment teeth.
- Resistance to displacement in any direction by occlusal forces.
- Framework design should limit stresses on luting cement and bonded interface.
- Axial reduction and guide planes on the proximal surface with a faciolingual lock.
- Maximum coverage of virginal enamel (180° wrap-around) for retention and bonding area.
-
Posterior tooth preparation:
- Retainer design with occlusal rests, retentive surfaces, and proximal wrap to resist occlusal and torquing forces.
- Mandibular molars require a single-plane lingual wall reduction.
- Maxillary molars require two-plane reductions due to occlusal function and cusp taper.
-
Finish line:
- Chamfer finish line (0.3-0.5 mm), 1 mm away from gingival margin (supra-gingivally).
- Knife-edge interproximal finish line to avoid enamel penetration.
- 180° wrap-around extending buccally beyond the distobuccal line angle in the mesial abutment and mesiobuccal line angle in the distal abutment for resistance to lingual displacement.
- Proximal walls should be parallel or have slight taper.
-
Proximal grooves:
- 0.5 mm depth to resist torquing forces.
- Two parallel grooves: One near the facioproximal angle adjacent to the edentulous space and one at the opposite lingoproximal corner.
-
Occlusal seat:
- Extend on the cuspal slope of the lingual cusp.
-
Mandibular first premolar preparation:
- Placement of a rest seat would leave insufficient solid tooth structure in the lingual cusp.
All-Ceramic RBB
- High-strength, non-etchable ceramics like zirconia are preferred.
-
Surface treatment of ceramics:
- Zirconia requires sandblasting or Rocatec system due to its un-etchable nature.
- Manufacturers have developed primers for bonding resin cement to zirconia, un-etchable ceramics, and metals.
- Z-Prime Plus enhances bond strength with unique MDP phosphate monomer composition.
- Research supports the long-term bonding of MDP phosphate monomers to zirconia, whereas silanes do not contribute to adhesion.
-
Surface conditioning:
- Increases the critical surface energy for adhesion.
- Uses silanes or primers.
-
Silane coupling agents:
- Polymerize with hydrophobic resin-composite monomers.
- Bond with hydrophilic inorganic hydroxyl-rich (-OH) surfaces (silica and silica-coated surfaces).
- Phosphate-based primers are effective in bonding to zirconia.
-
Surface Treatment of Tooth Structure:
- Acid Etching technique: Tooth is cleaned with pumice, washed, and dried. Etched with 37% phosphoric acid for 30 seconds, washed, and dried.
- Laser Etching technique: Tooth is cleaned with pumice, isolated, and dried. Laser initiator is applied. Etched with laser for 60 seconds. Excess initiator is removed, and the tooth is washed and dried.
-
Bonding Resin:
- Conventional resin cement: Modified unfilled/filled composite resin with thin film thickness. Sets within 60-90 seconds under the casting, but not at the margins exposed to air.
- Light-cure the margins or apply Oxyguard II to exclude air. Rinse away Oxyguard II after 2 minutes and remove residual cement.
- Major finishing, polishing, and occlusal adjustments should be performed before bonding.
Causes of Failure of Resin Bonded Retainers
-
Improper patient selection:
- Gender: Masticatory forces are stronger in men, but gender doesn't seem to affect longevity.
- Parafunctional habits: Parafunctional habits and occlusal interference can lead to higher debonding rates. Bruxism is a significant stress factor.
- Span length: Resin-bonded bridges are limited to single tooth missing. Increasing the number of pontics significantly decreases longevity.
- Existing old restorations or caries: Class III composite restorations should be replaced to promote adhesion. Large class IV caries or old composite restorations have questionable prognosis with resin-bonded restorations. Full coverage restoration is more advisable for long-term performance.
- Improper tooth alignment (poor path of insertion).
- Insufficient vertical length of the abutment.
- Insufficient enamel for bonding.
- Improper alloy selection: Base metal alloys like Nickel Chromium or Cobalt-Chromium are preferred over gold alloys due to their higher modulus of elasticity.
-
Improper tooth preparation:
- Insufficient lingual and proximal reduction.
- Incomplete 180° wrap-around extension.
- Lack of proximal grooves.
- Lack of accommodation to mandibular excursion (protrusion).
-
Failure of Bonding Procedure:
- Contamination.
- Inappropriate luting cement.
- Incorrect manipulation of cement.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the definition, advantages, and disadvantages of resin bonded retainers in dental practice. It highlights their conservative preparation techniques and aesthetic benefits while also addressing longevity and limitations. Test your knowledge on this innovative dental restoration method.
