Fiber-reinforced composite fixed dental prostheses in the anterior area: a 4.5-year follow-up.

STATEMENT OF PROBLEM: Currently, fiber-reinforced fixed dental prostheses (FRC FDPs) are a reliable treatment option for the restoration of single missing teeth in the anterior area. PURPOSE: The purpose of this study was to evaluate the survival of direct and semidirect fabricated FRC FDPs in the anterior area and to rate the quality of the outcome. MATERIAL AND METHODS: Twenty-four participants (12 men, 12 women) were included in the investigation. The prostheses were made of preimpregnated, unidirectional fiber-reinforced composite (FRC) (everStick, GC) by using a direct (n=18) or semidirect (n=6) technique. Eleven FRC FDPs had been placed in the maxilla and 13 had been placed in the mandible. Follow-up intervals were recorded, and the prostheses were classified as success (successful), survival (unfavorable event but still in vivo), or failure (lost). Quality was rated according to the modified United States Public Health Services (USPHS) or Ryge criteria. RESULTS: The FRC FDPs evaluated in this study showed an overall survival rate (success) of 72.6% and a functional survival rate (success + survival) of 85.6% (median follow-up 54 months). According to the USPHS/Ryge criteria, most of the restorations displayed excellent or good quality. Survival analysis was performed by the Kaplan-Meier method. CONCLUSIONS: The FRC FDPs evaluated in this study showed promising survival rates and good quality after a median follow-up period of 4.5 years (quartile range 3.5 to 6.3 years), thus indicating that FRC FDPs are reliable treatment options for the restoration of single missing teeth in the anterior area. The use of preimpregnated FRC materials with higher fiber content might improve the clinical fabrication of FRC FDPs but does not influence their long-term clinical survival.

An evidence based approach for the provision of resin-bonded bridgework.

Resin bonded bridgework (RBB) is a technique often overlooked by practitioners despite a large amount of evidence supporting the technique. In Cork University Dental School an evidence-based, standardised approach for the delivery of RBB by undergraduate students has been developed over the past 10 years. The aim of this study was to evaluate the success of this standardised approach on the delivery of RBB by students. 222 bridges were reviewed which had been delivered over a 6 year time period between 2002 and 2007. A success rate of 84.1% was achieved with a mean survival time of 41 months. This study illustrates that predictable and highly successful RBB can be delivered by inexperienced clinicians using an evidence-based, standardised approach.

Estimation of the retainer height biomechanical contribution in posterior resin-bonded fixed partial dentures: a structural-thermal coupled finite element analysis.

This study determines the RBFPD (resin-bonded fixed partial dentures) biomechanical aspects to retainer height using structural-thermal coupled finite element (FE) analysis under normal (37°C) and high (51°C) oral temperatures. Three RBFPD FE models with different retainer heights (100, 75, and 50% of the distance from 2 mm above the CE (cementum-enamel) junction to the occlusal surface) were created using image processing, contour stacking, and mapping mesh procedures. After FE model validation, the maximum first principal and von Mises stresses in the remaining tooth (σ(T)) and prosthesis (σ(P)), were recorded for all models under structural-thermal coupled analyses. The simulation results showed that the σ(T) and σ(p) values decreased with greater retainer height as a result of the increasing prosthesis stiffness and maximizing bonding area between the enamel and retainer at normal oral temperature (37°C). However, no significant stress differences were found according to the retainer height varying dimensions at high (51°C) temperatures. The RBFPD retainer height biomechanical response is dominated by the structural analysis result (at 37°C) and it is recommended that the prosthesis retainer have as great a height as possible to decrease the stress values.

Resin-bonded fixed partial denture retention: a retrospective 13-year follow-up.

A total of 51 resin-bonded fixed partial dentures (RBFPDs) were inserted under controlled clinical conditions and evaluated over a period of 13 years. Three levels of survival were defined: complete survival (no debonding); functional survival (loss of retention on one occasion with rebonding of the original RBFPD); and multiple survival (loss of retention on several occasions with rebonding of the original RBFPD). The effect of the aetiology, location (anterior/posterior or maxillary/mandibulary) and number of units of the missing tooth on RBFPD survival rates were investigated. The mean survival times and confidence levels were determined for each survival category, using the Kaplan-Meier procedure. The relative risks were calculated by the Cox regression procedure. The overall complete survival level of the study population at the end of the follow-up period was 85 months +/- 13%. Rebonding the RBFPDs once increased the overall functional survival rate to 112 months +/- 10% and multiple rebonding led to a further increase to 131 months +/- 8%. The RBFPD placement under conditions of good periodontal support in which orthodontic treatment was not required, such as trauma among other factors, showed significantly higher survival rates than those placed after periodontal or orthodontic treatment. This indicates that, under both these conditions, RBFPDs may serve as long-term or semi-permanent restorations.

Clinical longevity of resin-bonded bridges bonded using a vinyl-thiol primer.

The purpose of this study is to clinically confirm the adhesive effect of a vinyl-thiol primer (V-Primer) for precious alloys. Further, we examined the failure of resin-bonded bridges (RBBs) in order to improve the clinical longevity of RBBs, and to analyse the causes of failure. Twenty-six RBBs were bonded with V-primer and Super Bond C & B between May 1987 and December 1997 in the Dental Clinic of the Health Sciences University of Hokkaido. The RBBs were made of silver-palladium-gold alloy or metal-ceramic gold alloys. V-primer was effective in bonding Super Bond C & B to the RBBs made of silver-palladium-gold alloys. Ten prostheses had functioned satisfactorily for 8-11 years. However, six of the 26 RBBs had become detached. In four of the six failed RBBs, the type of bond failure was a mixture fracture in the resin-enamel interface. Our results suggest that: (1) V-primer is effective on RBBs made of silver-palladium-gold alloys. (2) Mechanical retention is necessary for retainers to improve the longevity of RBBs when the V-primer is applied to RBBs made of precious alloys without copper. (3) The RBB should not be applied to abutment teeth that have differences in tooth mobility.

[Cantilever resin-bonded bridges with one adhesive surface. A review of the literature]. / Eénvleugelige adhesiefbruggen nader bekeken. Een literatuuronderzoek.

Conventional resin-bonded bridges are designed with adhesive surfaces on both sides of the dummy. As a consequence both abutment teeth are rigidly connected to each other. Loading of the abutment teeth or dummy will lead to wringing forces in the cement. Adhesive bridges with one adhesive surface are actually cantilever bridges. Theoretically this type of bridges will be less prone to wringing forces due to loading. However, long term research into the performance of cantilever resin-bonded bridges (RBBs) is hardly available. The results of research into the longevity of conventional RBBs differ remarkably between Europe, and the United States and Japan. These difference are discussed in this article. This article compares the fixed-fixed design RBBs with the cantilever RBBs. The differences are discussed based on eight articles, the earliest being published in 1991, which are dedicated, completely or partially, to the subject of cantilever adhesive bridges. One can conclude that in The Netherlands RBBs are wrongly considered to be unreliable. On the contrary, they appear to be reliable and predictable restorations provided their preparations meet the right standards. Although a number of authors conclude that cantilever RBBs are performing better than their fixed-fixed design counterparts in similar situations, further research is needed concerning the longevity of this type of adhesive bridges.

Comparison of resin-bonded prosthesis groove parallelism with the use of four tooth preparation methods.

STATEMENT OF PROBLEM: A precise preparation is required to develop resistance form resulting in mechanical stability of the framework for resin-bonded prostheses (RBPs). PURPOSE: The effects of 4 methods of tooth preparation (freehand, guiding pin, extraoral parallelometer, and intraoral parallelometer) on the deviation of proximal grooves from a preestablished path of insertion (guide planes) were investigated under clinical conditions. MATERIAL AND METHODS: Tooth preparation of proximal grooves was performed by 32 dentists on resin substitutes of posterior segments intraorally with a single test patient. A Latin-square randomized cross-over design was selected as the experimental design. RESULTS: The significant least angular deviation of proximal grooves from path of insertion was achieved with an intraoral parallelometer (mean +/- SD 3.15 +/- 1.67 degrees). Compared with freehand tooth preparations (4.37 +/- 2. 11 degrees), neither use of a guiding pin (4.10 +/- 1.62 degrees) nor an extraoral parallelometer (5.06 +/- 2.33 degrees) improved the results. CONCLUSION: Divergence of guiding grooves from path of insertion was reduced with the use of an intra-oral parallelometer. This should improve mechanical stability of posterior RBPs.

[Five year survival of posterior adhesive bridges. Influence of bonding systems and tooth preparation]. / Vijfjaarsoverleving van adhesiefbruggen in de zijdelingse delen. De invloed van hechtsysteem en preparatievorm.

The present study reports the final analysis of a randomized controlled clinical trial in which different designs of posterior resin-bonded bridges were evaluated for a period of at least 5 years. The operational hypothesis was that the bonding system and the preparation design used in posterior resin-bonded bridges have an influence on the survival and clinical functioning of these restorations. Survival in this study was defined at two levels: (1) 'primary' survival (survival without any debonding), and (2) 'functional' survival (survival including loss of retention on one occasion and successful rebonding of the original resin-bonded bridge without further debonding). Preparation of grooves in abutment teeth for posterior resin-bonded bridges appeared to be beneficial to their chance of survival. Resin-bonded bridges placed in the maxilla have a better prognosis than those made in the mandible. The bonding systems used in this study (etching/Clearfil F2, sand blasting/Panavia EX and silica-coating/Microfill Pontic C) appear to have no influence on the chance of failure with regards to the 'primary' survival. In rebonded posterior resin-bonded bridges, the bonding system silica coating/Microfill Pontic C was more retentive than the other systems tested.

Análisis de diseños de preparaciones dentarias en prótesis fija adhesiva / Analysis of tooth preparation designs in resin-bonded fixed prostheses

Este estudio confirma que los diferentes diseños de preparaciones dentarias para prótesis adhesivas influyen directamente en la retención de estos aparatos. El grupo posterior de la cavidad bucal reveló los mejores valores promedio de resistencia significativos a las fuerzas de clivaje. El diseño más efectivo fue el No.2, que presentaba ranuras proximales como mecanismo de retención adicional significativamente mejor que los otros dos diseños. Los resultados obtenidos permitirán orientar al clínico en cuanto a la elección de un diseño apropiado en un determinado sector de la cavidad bucal y en relación a la presencia o no de un antagonista protético removible o natural, al momento de optar por la decisión de rehabilitar pacientes con prótesis adhesivas

[Composite (etched) bridge]. / Composiet-(ets)bruggen.

An adhesive or resin-bonded bridge is a tooth saving construction for the replacement of a lost tooth, especially when the abutment teeth are relatively sound. In this article an overview is presented of the different types of resin-bonded bridges, their advantages and disadvantages and their indications. The direct methods are very suited for the immediate replacement of a lost anterior tooth. The all composite adhesive bridge has a survival rate that is surprisingly good.