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Resin Bonded Bridges

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2

Conventional Bridges

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3

Drawbacks of Conventional

Bridges

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4

Drawbacks Cont

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5

RESIN BONDED BRIDGES

- past1973

Rochette Design with perforated metal retainers

for Periodontally mobile teeth

Macro--mechanical retention

Limited extension of retainer

Acrylic resin

Howe & Denehy

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Mechanical retention

Mesh retention

Salt crystal, beads & crystals

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Micro--Mechanical retention

Grit blasting (50--250 u Alo)

Electrolytic etching

Chemical etching (Hydrofluoric acid)

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Micro-chemical retention

Chemically active resin

Alloy surface treatment

silicoating

tin plating /

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RESIN BONDED BRIDGES

- present

Non-perforated, non-precious metal

retainersCemented with resin cements

following sandblasting

Micro-mechanical and chemical

retention

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Fixed - fixed RBB

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Advantages of RBB

Conservative

Easy to place

AestheticRelatively reversible

Cheaper

Less chair time

Patient preference

No anesthetic needed

supra--gingival margins

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Disadvantages of RBB

More de--bond

Caries after partial debond in FFRBB

Aesthetic problems- Incisal shine-

through

Occlusal metal

extension

No space correctionNo alignment correction

Limited tooth replacement

Trial prosthesis not usually possible

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High rate of debonding on

RBB ?

Torsional stresses on cement layer

Interabutment stresses developed due to

function, Parafunction and mandibularflexion

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How to overcome ?

Development of adhesive techniques

Proper case selectionMinimizing the Stresses on cement layer

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Indications for RBB

Un--restored / minimally restored

Abutments

Sufficient good quality enamel

Sufficient inter occlusal clearance

Young patient

Short span

Intermediate prosthesis

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Contra - indications

Heavily restored teeth

Little enamel to bond to

Poor quality enamelExcessive occlusal load, Parafunction

Difficulty in isolation for moisture control

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Forces affecting Prostheses

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Guidelines for tooth

preparation1. Preparation within enamel whenever

possibleknife edge margins

2. Maximizing the surface area for bonding-Axial preparation to

lower the survey-line.

Lingual or palatal path of insertion

only occlusal and proximal

surfaces need preparation

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Axial preparation tolower the survey--line

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3. Abutment resistance formwraparound

occlusal coverage

use of resistant features

grooves / pinholes

* Proximal grooves have been

recommended for anterior RBBs to

compensate for the lack of wrap around

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Grooves, pinholes, occlusal overage

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4. Retainer resistance formnecessaryto resist functional and prafunctionalforces that flex the retainer and breakthe cement bond

retainer thickness - > 0.7 mm for

posterior teeth

changing geometric configuration

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5. Occlusal adjustments

Occlusal contact on cantilevered pontic

should be kept lightBetter to have the occlusion on the

retainer

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Unfavorable Occlusal contact s on pontic &abutment

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6. Posterior abutment

mid palatal groove offers some

resistance for occlusal loading on

the pontic

C shape retainer distort easily

D shape retainer

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mid palatal groove

offers some resistance for occlusal loading

on the pontic

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C shape retainer

distort easily

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D shape retainerwith occlusal strut

Do not distort easily

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If occlusal clearance sufficient

coverage of palatal /

lingual cusp

- retainer rigidity- surface area for bonding

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coverage of palatal / lingualcusp

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7. Non rigid connectors for Long spanFFRBB

Long span RBB clinically less retentive due to

interabutment stresses developed duringfunction, parafunction and mandibular flexion

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Non rigid connectors for

Long span FFRBB

Movable joint

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2- unit cantilevered RBB vs.

F-F counterpart

Clinical researches have shown 2- unit

cantilevered RBBs are equally or more

successful when compared to F-Fcounterpart

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di

Other advantages ofCantilever RBB

More conservativeQuicker to prepare

Easier to record impression

Simpler to cement

Less lab feeNo differential loading

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Retention rate of RBB

46% at 11 months to

93% over 11years

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Tooth preparation

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Resin Cements

Micro--mechanical bond to acid etched

Enamel and Dentine

Chemical and Micro-mechanical bond to

sand blasted metal

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Resin Cements

Micro-mechanical bond to acid etched Enamel

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Resin Cements

Micro-mechanical bond to acid etched

Dentine

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PANAVIA F

Shear bond strength

to Enamel 40 MPa

to Dentine 20 MPa

to Precious Metal 40 MPa

MDP absorbs chemically to metalliion

78% filler content superior physical &

mechanical properties

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SUPER-BOND C & B

Bond strength

to enamel - 15 Mpa

to dentine 17 Mpa

Ni--Cr

30 Mpa, Co--Cr

31 MPa4-META forms a hydrogen bond

with O2 / OH of oxide layer

More flexible bonding

Low compressive strength & abrasiveresistance

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Future

Cantilever 2 unit

Incisors

Upper 2nd premolarsSome upper 1st premolars, lower

premolars, canines

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CASE - 1

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CASE - 2

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CASE - 2 Cont

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CASE - 2 Cont..

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Case - 3

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Case - 4

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Case - 5

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Case5 cont

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Case - 6

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