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Prosthodontics Supporting Your Practice

What is the Role of resin-Bonded Bridges in the Dental Practice?

Dr. John O’Keefe spoke with Dr. Neena DSouza about the literature review they did on resin-bonded bridges, their longevity, success rate and appropriateness. Their conversation evolved around a case that Dr. DSouza recently treated using a resin-bonded bridge.  

Dr. Neena DSouza is a Prosthodontist in a multi-specialty practice in Mississauga, Ontario. She has kindly volunteered to answer your questions and you can reach her by email: neena.dsouza@bellnet.ca

We hope you enjoy the presentation and we welcome your feedback, suggestions and questions. You can always email us at oasisdiscussions@cda-adc.ca or call our toll-free number 1-855-716-2747.

Until next time!

CDA Oasis Team

Highlights

  • Resin-bonded bridges are often underutilized because of the misconception that they debond frequently. A literature search revealed that they actually have an excellent prognosis, if done appropriately in the appropriate situations.
  • Resin-bonded bridges can be used as long-term temporaries in young adults who are not yet ready for implant replacement or as permanent fixtures in adult patients who might want a more conservative form of treatment.
  • The clinical case: a 38-year old woman was unhappy with the aesthetics of her smile, particularly with the irregularity in the spaces between the maxillary incisors as well as the irregular spaces between the mandibular incisors as well as the size and shape of a prosthetic on 4.2. 
  • Working in a multi-specialty office, Dr. D’Souza sought the professional opinion of her colleague Orthodontist and Periodontist and presented the patient with few treatment options. The patient opted for a resin-bonded bridge and the treatment outcome was very satisfactory for the patient. 

Interview Transcript

What is the Role of resin-Bonded Bridges in the Dental Practice? (PDF)

Oasis Moment (0.56″)

 

Full Case Presentation (11.16″)

 

5 Comments

  1. Cliff Leachman July 4, 2018

    Working in a downtown practice we see lots of tourists from out of town. Pretty common to see their Maryland bridges in their hands and expecting to put them back in with ease. Did one last week from Australia, honestly I HATE them. Certainly they can work in the right situation, but those are few and far between, if you like to travel, get it done properly please….

    Reply
  2. Anonymous July 13, 2018

    Good evening,

    Great case with resin bonded bridge. I do have a couple of questions though.

    1) what was the reason you did not just redo the crown on the existing implant post orthodontic treatment?

    2) I have had way better success with single wing resin bonded bridges. Can you comment on 1 wing bridges. I would often find with 2 wing bridges that 1 wing would debond over time. I am aware that the width of the Pontic and the thickness of the connector are very important.
    Thanks,

    Reply
    1. Dr. Neena D’Souza July 13, 2018

      1. What was the reason you did not just redo the crown on the existing implant post orthodontic treatment?

      Answer

      The implant and attached abutment were a single unit. It’s emergence profile could not be altered and it’s position precluded placement of an esthetic crown within the orthodontically altered and newly established mandibular anterior teeth position. Hence the implant was sectioned and the 42 replaced with the RBB.

      2. I have had way better success with single wing resin bonded bridges. Can you comment on 1 wing bridges.

      Answer

      The literature reports high success rates with single wing RBB. Traditionally, these were cemented with minimal abutment preparation. Therefore if case selection has been adequately done there is no reason why it should not be successful. Debonding is an issue with dual wing RBB. Therefore if the RBB is the treatment of choice for example if it is intended to be used as a permanent restoration the recommendation for dual wing RBB is interproximal box preparation on the adjacent abutment teeth.

      Dr. Neena D’Souza

      Reply
  3. Dr. Larry Stanleigh September 7, 2018

    The weak link, as I understand it, is the bond between the cement and the zirconia. Since you cannot silanate the zirconia, how are you certain the bond to the zirconia framework will be strong enough? Or are you also relying on mechanical retention with the inter proximal box prep?

    Beautiful work and a lovely conservative non-invasive solution.

    Reply
    1. CDA Oasis November 15, 2018

      On behalf of Dr. Neena D’Souza:

      The zirconia framework was sintered overnight and acid etched with low melting fluoride compounds such as Ammonium Hydrogen Fluoride and Potassium Hydrogen difluoride. However the weak link correctly is the bond between the cement and the zirconia. We therefore rely on mechanical retention as we would with any other metal based restorations. Acid etching is one method of creating mechanical retention. The interproximal box preparation also contributes to the mechanical retention of the bridge. A positive seat for the bridge is obtained with the box preparation and combined with the adhesive cement will effectively aid in retention.

      Reply

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