RBB Flashcards
Where do we need RBB?
For long standing gaps
When do we need RBB?
- Hypodontia pt’s
- Restore function (speak, chew)
- Unwanted tooth movements ( overeruption, drifting)
Why do we use RBB?
- Minimally invasive
- Rely on composite resin cements for retention (bonded chemically to both the tooth surface and metal alloy)
Pros of RBB?
- Minimally invasive, no LA needed
- High predictable success rate
- Soft tissues are not disturbed
- Relatively reversible
- Less demanding to fit than other forms of tooth replacement
- Less clinical time
- Cheaper
- Aesthetic
- Failure is less catastrophic
Cons of RBB?
- Debonding
- Longevity
- Aesthetics (metal wing)
What factors should be considered during case selection for RBB?
- OH (RBB may be preferable in pt with no history of periodontal disease or caries)
- Age (older pt may accept short dental arch, temporary option for younger pt’s)
- Pt expectations (manage aesthetics &longevity expectations)
what factors should be taken into consideration when placing RBB?
- Identify who is suitable
- Think about medical history
- Check perio and pulpal status
- Check abutment teeth
- Check if pt has good dexterity to maintain OH
- Check pt expectations
- Explain pros, cons and maintenance to patient
What type pontic do we use for immediate RBB? and what are its disadvantages?
OVATE pontic
- post extraction it forms a dimple and since it engages the tissue it is aesthetically pleasing.
- Not a good long term solution due inflammation build up underneath the pontic which is undesirable
What is the ideal pontic for patients and why?
Porselin infused to metal modified ridge lap
- The buccal aspect of the pontic would engage apically to the tissue
- It is ideal since can clean with interdentalbrushes and superfloss
what material is a pontic made out of?
Well polishes porcelain ceramic over the metal substructure
what are the components of bridge work?
- Abutment
- retainer (wing)
- Pontic (teeth)
- connector (holds the pontic and wing together)
what is the ideal thickness and height of a retainer?
0.7 mm thickness
3 mm height (not aesthetically pleasing might see metal)
why and how should the retainer be surface treated?
to enhance micromechanical retention
- done using sandblast with 50 micron alumina
why is a single wing better and which aspect should it be placed?
- it is better due to caries risk
- wing should be placed on the distal aspect
what material is the retainer made of?
non precious metal substrate
- nickel chronium alloy or
- cobalt chronium alloy
are root treated tooth good as abutmetments?
no but may need crown
how to cement RBB?
- use rubber dam
- always follow manufacturers instructions
- when its a temporary crown use GIC or resin modified GIC (stronger)
otherwise use resin cement
what happens every time the RBB comes off?
poor prognosis make sure to clean off cement with ultrasonic scaler and ideally sandblast
