RESIN BONDED BRIDGES

RBBS are a fixed partial denture that is luted to tooth structures, primarily ____ , which has been _____ to provide _____ ____ retention for the resin luting agent

enamel

etched

micro mechanical

When to use RBBs??? (2)

Replacement of missing teeth with a focus on maximum conservation of natural tooth structure

Usually for missing lateral incisors

Rochette Bridge: Uses ____ perforations of a ___ ____ to provide _____ retention

flared - metal casting - mechanical

Mainly used for periodontal splinting but evolved to include pontics?

Rochette bridge

Rochette bridges are still limited to ____ teeth with minimal ______

Bonded with ____ _____ composite

anterior

occlusal contacts

heavily filled

Limitations of Rochette:

______ of the metal retainer by the _______

Exposure to ____ of the ____ at the perforations

Limited _____ of the metal provided by the perforations

Weakening - perforations

wear - resin

adhesion

What type of RBB uses Electrolytic etching of cast base metal retainers to create undercuts?

Maryland bridge

Advantages of Maryland Bridge:

_____ is improved

Retainers can be ______ and still resist _____

The oral surface of the cast retainers is highly _____ and resists what

Retention

thinner - flexing

polished - plaque accumulation

Disadvatnages of of Maryland Bridge:

Lack of attention to detail can result in _____ or surface ______

_____ must be optimized for each alloy

Bonds ____ over time

electropolishing - contamination

Technique

degrade

What type of RBB does not rely on perforations or electrolytic etching

What do they use?

Adhesion bridges

Adhesion promoters (primers) such as 4-META and 10-MDP

T or F: Adhesion Bridge adhesion systems have higher bond strength to particle abraded base metals compared to electrolytic etching

T

Panavia is an example of what?

Show ecellent bond strength to parteicle abraded what?

Recent versions did what?

Adhesion bridge

Ni-Cr and Co-Cr

Incorporate a self etching primer for boonding

Indications for RBB:

______ teeth with favorable _____

Replacement of missing teeth in who?

Patients with ______ and _____ edentulous spaces not suitable for the placement of implants

Patients with missing single-teeth with healthy ____ _____ that are not willing to undergo ____ ____

Patients with _____ contraindications for implant surgery

______ restoration*

____ phobia

Anterior - occlusion

adolescents and young adults

narrow single-tooth

Adjacent teeth - implant surgery

medical

Provisional

Needle

Contraindicatons for RBBs:

Replacement of missing ____

Restored or damaged _____

_____ edentulous span

Compromised ____ (deficiency or defects)

_____ abutment teeth

______ habits

____ bite

____ teeth

canines

abutments

Long

enamel

Small

Parafunctional

Deep

Crowded

Materials for RBBs?

Metal ceramic

All ceramic

Lithium Disilicate

Zirconia?

Framework can be layered with a more _______ ceramic

esthetic

Factors affective success of RBBs??? (3)

Case selection

Bridge design

Clinical technique

Case selection Factors Affecting Success:

___ factors

_____ selection

-______ features

Patient

Abutment

Occlusal

Bridge Design Factors Affecting Success:

_____ _____ coverage

_____ features

______

_____ design

Retainer wing

Technical

Aesthetics

Pontic

Clinical Technique Factors Affecting Success

Need for tooth _____

_____

_____ preparation

prep

Cementation

Ridge

Abutment Selection:

Needs to be enough _____ available

Must be ___ and _____ healthy

Previous _____ or tooth ____ may compromise surface area

_______ or ______ teeth should be avoided

Usually what teeth?

Enamel

endodontically and periodontally

restorations - wear

Crowded or angled

canine or central incisor

Two factors evaluated to choose the most appropriate abutment tooth??

size of the palatal/lingual surface area that can be used for the bonding

shape of the palatal/lingual surface - ideally oval or round to allow for a "wrap- around" design of the retainer

Function of prepping the proximal surface for an RBB:

Reduces ______

This increases _____ dimensions and maximizes _____- ____ for bonding.

Limits ____ ____ ____ therefore improves _____ .

Reduces _______ space and therefore _____ ____ (aesthetics)

bulbosity

connector - surface area

path of insertion - retention

embrasure - black triangles

If no prep is carried out, the _____ is often too ____

What will increase its dimension?

Connector - thin

Cutting small mesial guide plane

Function of cingulum rest:

Resist ____ stress within the _____

Aids bridge _____ during _____

Provides a definite _____ ____

shear - cement

positioning - cementation

vertical stop

What other parts of prep are involved in RBBs??? (3)

Function?

Vertical grooves - improve resistance

Cervical chamfer - avoid overhand, helps lab

Occlusal clearance - material dependent

No Prep RBBs advantage?

Prep may result in dentin exposure

If no cervical preparation is carried out, finishing the wing with a ____ and _____ margin should facilitate oral hygiene procedures

polished and rounded

RBBs are more successful as a _____ than as fixed-fixed restorations

cantilever

Any flexion of the bridge will exert stress on the cement, eventually causing what?

Fatigue failure

______ are highly rigid and can be used in thin sections without risk of flexing, this makes them ideal for RBB

what is minimal thickness?

Base metal alloys

.7mm

_____ connectors may shine through the translucent incisors causing them to appear ___

Metal - gray

Most common pontic for RBBs?

Why?

Esthetic Demands?

Modified ridge lap - esthetics and hygeine

Ovate - good emergence profile

Connector Dimensions Depend on what?

Zirconia?

Ceramic?

Material

9mm squared

16mm squared

Advantages of RBBs:

______

Minimal potential for ____ _____

______ usually not required

______ preparation

Easy ______ making

_____ restoration usually not required

Reduced (2)

Conservative

pulp trauma

Anesthesia

Supragingival

impression

Interim

Chair time and cost

Disadvantages of RBB:

Enamel ______ may be necessary

Space ______ is difficult

Good ______ of teeth needed

Can't improve ____ or _____ of abutment

____ ?

modifications

correction

alignment

shape or size

Survival