Resin Bonded Bridges

Resin Bonded bridges, types, functions and success rate of different type of bridges.

1. Resin Bonded Bridges By: Dr. Almas Muhammad Arshad

2. What are RBB’s? Minimally invasive prosthodontic replacement of missing teeth.

3. INDICATIONS Short span edentulous areas Pt unwilling or unsuitable for surgical treatment. Needle phobic pts. Post orthodontic fixed retention In periodontally compromised - Splinting

4. CONTRA INDICATIONS Heavily restored abutments Small sized abutments – Peg Laterals Mal- alligned abutments Mobile abutments Long span edentulous area Allergy to base metal alloys

5. SUITABLE ABUTMENT?

6. Assess the:

7. SIZE: Larger enamel surface – better bond. Small sized abutments (Peg laterals)

8. RESTORATIVE STATUS: Minimally restored with good quality enamel Resurfacing old restorations GIC/Amalgam = ? Composite = ? ENDODONTIC STATUS: Vital teeth, without any pulpal pathosis

9. PERIODONTAL STATUS: No active periodontal disease . Less than 50% bone loss, a fixed-fixed type of RBB will act as a splint – is acceptable More than 50% bone loss, RBB should be reconsidered.

10. ANGULATION: Assessing the angulation – should be suitable Reducing bulbosity to increase the connector height POSITION: Distal abutment with mesial cantilever is most suitable

11. DESIGNING THE RBB Depends upon: Degree of coverage Number of abutments Framework Rigidity

12. Degree of Coverage: The literature suggests that the best outcome for adhesive bridges can be achieved where maximum enamel coverage

13. Anterior teeth: S hould include the entire palatal/lingual surface, as well as extending on to the incisal edge . Endodontically Restored teeth- retention from the access cavity

14. Posterior Teeth: Palatal/ lingual cusps Occlusal surface

15. NO. OF ABUTMENTS Less no of abutments, low rate of failure. Evidence shows that fixed-fixed type RBB has twice the rate of failure compared to Cantilever type Partial Debonding .

16. FRAMEWORK RIGIDITY Regidity depends on the thickness of the framework. Thickness should be at least 0.7mm for anteriors . Thickness should be increased as the span of bridge increases

17. Bridge Designs Maryland Bridge

18. Rochette Bridge

19. Virginia Bridge

20. CONCLUSION Like in all restorative cases, Careful case selection and attention to detail are critical for the successful provision of RBBs.