Resin Bonded Bridges Flashcards
Indications for RBBs
Abutment teeth minimally restored
Sufficient amount of enamel
Patient unwilling or unsuitable for surgical treatment such as implant placement or bone grafting
Fixed retention after orthodontic treatment
Splinting periodontally compromised teeth to improve comfort, although significant differential mobility may be a contra-indication
Needle-phobic patients
Contra-indications for RBBs
Heavily restored abutment teeth with reduced enamel available for adhesion
Small abutment teeth, eg peg laterals, microdont teeth with a reduced surface area for adhesion
Mal-aligned abutment teeth which will result in a poor path of insertion and poor aesthetics
Significant differential mobility of abutment teeth where more than one abutment is incorporated in the design, as this frequently leads to de-bond
Allergy to base metal alloys, eg nickel (although nickel-free alloys exist)
Substrate bond strength hierarchy
Enamel
Resin composite
Glass Ionomer cement
Dentine = amalgam
Factors to consider for RBB abutment teeth
Size
Restorative status
Angulation, position and bulbosity
Periodontal status
Ideal characteristics to make a RBB rigid
Minimum 0.7mm thickness of NiCr retainer
Increase connector height
Extending framework over palatal/lingual and occlusal surfaces
Ideal design features for a RBB
Maximal lingual/palatal and occlusal coverage
Long connector height
0.7mm thick retainer
Light ICP contact or pontic and ideally no excursive contacts
Thin cement space
Different RBB materials
Metal framed RBB
Fibre-reinforced RBB
All ceramic RBB
RBB characteristics of failure
De-bonding of retainer
Fracture of framework
Greying effect of abutment tooth by metal wings
Caries and periodontal disease of abutment/s
Delamination
RBB survival literature
King, 2015
Pjetursson, 2017
Djemal, 1999
RBB tensile peel forces
Northeast, 1994
