Resin Bonded Bridges mary land bridge.ppt

prostho

1. Resin Bonded Bridges

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)

6. Bonded Pontics

7. Rochette Bridge

8. Maryland Bridge

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
obtainedobtained.

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 restorationposterior 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

24. Abutment Preparation

26. Sequence of
preparation

27. Laboratory Procedures

28. Bonding the restoration
Resin cements
PANAVIA 21
Rely X
Biscore

29. FINISHED RESTORATION