adhesive bridge

Question 1

What are the other names for adhesive bridges?

Answer 1

Resin retained bridgework (RRB)
Resin bonded bridgework (RBB)
Minimal preparation bridgework
Maryland bridge
Resin bonded fixed partial denture (RBFPD)

Question 2

Name 4 advantages of adhesive bridgework?

Answer 2

Any from:
- minimal or no prep needed
- no aesthetic needed
- less costly
- less surgery time
- can be used as a provisional restoration
- if fails, usually less destructive than alternatives

Question 3

Name 4 disadvantages of adhesive bridgework

Answer 3

Any from:
- rigorous clinical technique
- metal shine-through
- can de-bond, if de-bonds once, high chance it’ll do it again
- occlusal interferences
- no trial period possible

Question 4

Give 4 indications of adhesive bridgework

Answer 4

Any from:
- young teeth as it is less destructive
- good enamel quality
- large abutment tooth surface area
- minimal occlusal load
- good for single tooth replacement
- simplifies partial denture design

Question 5

Give 4 contraindications of adhesive bridgework

Answer 5

Any from:
- insufficient or poor quality enamel
- long spans
- excess soft or hard tissue loss
- heavy occlusal force eg - bruxists
- poorly aligned, tilted or spaced teeth
- contact sports

Question 6

How should the occlusion be considered when planning for adhesive bridgework?

Answer 6

1. Opposing dentition and overeruption of teeth
2. Parafunctional habits eg - bruxism
3. Look at dynamic occlusal relationship clinically and consider study models and diagnostic wax-ups

Question 7

Describe a direct resin retained bridge

Answer 7

Ideally uses patients own tooth but can use an acrylic denture tooth, a polycarbonate crown or a cellulose matrix filled with composite
Very useful in emergencies if a tooth needs to be extracted immediately or a tooth has been lost traumatically

Question 8

How is prep carried out for indirect adhesive bridgework?

Answer 8

Rarely done now:
- need lots of palatal/lingual coverage for a good bond
- 0.5mm supragingivally to allow cleaning
- 180º wrap around prep
- rest seats and proximal grooves used

Question 9

How are posterior abutments prepared?

Answer 9

Cut occlusal rest seats
180ºwrap around with chamfer finish
May want to use proximal grooves (rarely use these)

Question 10

What is done to increase micro mechanical retention in a nickel-chromium alloy

Answer 10

Sandblasting

Question 11

What can be used to provide a temporary tooth?

Answer 11

Essix retainer with tooth shaded in
RPD

Question 12

What are the stages of cementing an adhesive bridge with Panavia 21?

Answer 12

1. Isolate with dam
2. Etch tooth
3. Wash and dry
4. Apply primer for 30s
5. Air dry
6. Fit retainer coated with Panavia
7. Remove excess cement
8. Place oxygen inhibitor around cement for 3 minutes then wash off

Question 13

What should be done after an adhesive bridge is placed?

Answer 13

Check the occlusion
Demonstrate to the patient how to clean around an underneath the bridge with superfloss