Adhesive Bridge I Flashcards
Adv of adhesive bridges?
Seen conservative option replace teeth
Less destructive than conservative bridges
Viable for sound/ lightly restored dentition
What is Rochette bridge?
No true adhesive bridge - perforation in wings allowing cement extrude = mechanical retention
Types of retention of bridges?
Full coverage
Adhesive retainers
How are full coverage bridge provided?
Prep of abutment tooth for full coverage crown
How are adhesive bridges provided?
Minimal prep of abutment tooth involving only palatal and proximal surface
What are different types of abutment arrangements?
Fixed-fixed
Cantilevered
What is a fixed-fixed bridge?
Bridge has two abutment with pontic between
Pontic fixed either side
What is a cantilever bridge?
Bridge retained by one abutment
Tx options for missing teeth?
Do nothing
Removable - RPD
Fixed - bridge
Implant
10 parts of design criteria for adhesive bridge?
- Periodontal support
- Occlusal loading
- Conservation tooth tissue
- Cleansible
- Appearance
- Rigidity
- Quality of abutment tooth
- No of abutments
- Choice cement
- Contingency planning
What assess when assessing the quality of the abutment tooth?
Vitality of tooth
Restoration status of tooth
Any rotations
Oral hygiene
Main reason need to contingency plan?
Loss of vitality of abutment tooth
Ideal design of adhesive bridge?
Used for single tooth replacement
Cantilevered
Adv of cantilever bridges?
Pontic moves with abutment - reduces shear forces
Reduced caries risk
How prep tooth for cantilevered RBB?
Mesial and distal grooves
Light palatal chamfer
Cingulum rest
How thick does retainer need to be on a mnolar?
0.8mm thick - increased thickness if over occlusal surface
Why need correct thickness for retainer?
Rigidity - prevent flexion = peeling effect = debond
Ideal bonding area?
Maximise enamel bonding
Occluso-gingival and circumferential around tooth
Issue w/ increasing bonding area of framework?
Aesthetic and perio implication
Maximise SA w/o encroach gingival tissue and aestehtic zone
Two approachs to tooth prep and extension frameowrk?
- Full palatal coverage w/ no prep
2. Reduced palatal coverage w/ tooth prep
Why provide occlusal coverage on posterior teeth?
Resist displacement
Increase rigidity
Greater SA bonding
What is the connector?
Junction between pontic and retainer
Why need sufficient thickness of connector?
Prevent flexion = peeling = debond
Is height of connector important?
Yes needs to be at least 50% height of pontic
Why are grooves used in adhesive bridge prep?
Resistance lateral displacement
Increased retention
What want grooves on tooth to be?
Parallel - increase resistance and retention
Why are occlusal seat rests used?
Allow transmission of occlusal force along long axis of tooth
What is joining the occlusal rests called?
Occlusal bar
Advantage of preparing an occlusal bar?
Improve rigidity of retainer
What cements can be used for adhesive bridges?
Self cure composite lute
Anaerobic adhesive lutes
4-meta ahdesive lutes
Example of self-cure compoiste lute?
Calibra
What need with self-cure composite lute?
Non-adhesive
Needs used in combination w/ bonding system
Require etched metal substrate
Example of anaerobic adhesive lute?
Panavia
What need to use with Panavia?
Oxygaurd - ensure bonding takes place anaerobically
When a 4-meta adhesive lutes used?
Want speicifc bonding to metal and ceramic retainers
What materials are used for retainer?
Nickle chromium
Gold alloy
Ceramics
How choose abutment tooth?
Tooth position - angulation agreeable POI?
Crown shape - increased SA
Restorative status
Endodontic status
What teeth provide poor abutment teeth?
Maxillary lateral incisor - small w/ little SA to bond + small roots
Tilted teeth
RF teeth
Estimated survival of RBB?
87.7% at 5 years
Reason for failure RBB?
Debonding
Caries under retainer
Aesthetic failure
What should not do when designing bridge?
Use of double abutment - not required and difficult to clean
When could fixed-fixed adhesive bridge be used?
Mandibular incsiors
Design consideration of adhesive bridge?
Retainer thickness Bonding area Wrap-around Occlusal extension Connector design Length of span