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Wang S, Chen X, Ling Z, Xie Y, Chen C, Shen X, He F. Clinical and radiographic outcomes of implant-supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study. Clin Oral Implants Res 2024. [PMID: 38860608 DOI: 10.1111/clr.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The objective of this study is to analyze the clinical and radiographic outcomes of implant-supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible. MATERIALS AND METHODS Patients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single-unit crowns (ISSCs), ISFPCs, implant-supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three-unit ISFPN, ISFPC+ISFPC, or four-unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri-implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM). RESULTS The study included 87 patients and 152 implants. No implant loss occurred during an average follow-up of 3.48 ± 1.85 years (range: 1-7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow-up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four-unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p < .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6). CONCLUSION ISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri-implant bone stability and esthetics to adjacent ISSCs or ISFPNs.
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Affiliation(s)
- Siyuan Wang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhaoting Ling
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yiwen Xie
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Cong Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoting Shen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
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Kasem AT, Abo-Madina M, Tribst JPM, Al-Zordk W. Cantilever resin-bonded fixed dental prosthesis to substitute a single premolar: Impact of retainer design and ceramic material after dynamic loading. J Prosthodont Res 2023; 67:595-602. [PMID: 36775338 DOI: 10.2186/jpr.jpr_d_22_00226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
PURPOSE To evaluate the influence of retainer design and ceramic materials on the durability of minimally invasive cantilever resin-bonded fixed dental prostheses (RBFDPs) after artificial aging. METHODS One hundred caries-free human mandibular molars were prepared as abutments for all-ceramic cantilevered fixed dental prostheses using the following retainer designs: One wing (OW), Two wings (TW), Inlay ring (IR), Lingual coverage (LC), and Occlusal coverage (OC). Two ceramic materials were used: monolithic high translucent zirconia(z) and zirconia-reinforced lithium disilicate (ZLS2) (n=10). All restorations were adhesively bonded with resin cement. The thermocycling of the specimens were performed between 5°C and 55°C for 10,000 cycles and then exposed to 240.000 cycles of dynamic loading on a chewing simulator. All surviving specimens were loaded onto the pontic until failure using a universal testing machine. RESULTS The mean failure load ranged from 124.00 to 627.00 N for the zirconia groups and from 133.30 to 230.00 N for the ZLS2 groups. Regarding the materials, a significantly higher failure load was recorded in the zirconia groups than in the ZLS2 groups (P<0.001), except for OW (P=0.748). Regarding the retainer designs, a significant different failure load was recorded between the different designs except for IR and LC in the zirconia groups, IR and OC, OW and TW, and TW and LC in the ZLS2 groups (P<0.001). CONCLUSIONS Zirconia IR, LC, and OC can be used as cantilever RBFDP in the premolar region. The fracture resistance of the ZLS2 design was below the normal bite force and should not be recommended as the first option.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Kasem AT, Tribst JPM, Abo-Madina M, Al-Zordk W. Evaluation of different designs for posterior cantilever zirconia inlay-retained fixed dental prostheses in missing tooth replacement: Stage one results with 18-month follow-up assessment. J Dent 2023; 137:104688. [PMID: 37669722 DOI: 10.1016/j.jdent.2023.104688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/19/2023] [Accepted: 09/01/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This clinical study aimed to investigate the outcomes and survival rates of different variations of inlay-retained fixed dental prostheses (IR-FDPs) composed of monolithic zirconia ceramic. The IR-FDPs with a single-retainer design were used for replacing missing mandibular second premolars. The research evaluated the effectiveness and longevity of these prostheses in clinical settings. METHODS A total of 30 IR-FDPs (n = 30) were placed for 27 female patients who presented with missing mandibular second premolar teeth. For this study, the mandibular first molar was chosen as a retainer for the cantilever IR-FDPs and the study involved a random assignment of participants into three distinct groups, each comprising 10 individuals (n = 10). The criterion for the grouping was the retainer design: inlay ring (IR), lingual coverage (LC), and occlusal coverage (OC). The three groups included mesial inlay box with the same dimensions (3 mm height, 3 mm width and 2 mm depth). All IR-FDPs were manufactured using monolithic high translucent 3Y zirconia and the connector area to the cantilever pontic was adjusted to dimensions of 3 × 3 mm for all designs. The restorations were bonded using adhesive resin cement. The clinical and radiographic evaluations of the restorations were conducted for a duration of 18 months, following the modified FDI (World Dental Federation) criteria. RESULTS The restorations were observed in stage one for a period of 18 months. Only one restoration in group LC was debonded after 10 months and re-bonded. The clinical quality of all crowns and the patient's satisfaction were high. No adverse soft tissue reactions around the crowns were observed and only one abutment in group IR was endodontically treated after 12 months. CONCLUSIONS Zirconia cantilever IR-FDPs offer a viable short-term treatment option for replacing missing posterior teeth, providing esthetic and functional benefits while minimizing invasiveness. Over an 18-month observation period, these prostheses have demonstrated a remarkable survival rate of 100% and a success rate of 96.6%. These findings suggest the effectiveness and reliability of zirconia cantilever IR-FDPs as a short-term solution for replacing missing posterior teeth. CLINICAL SIGNIFICANCE Zirconia cantilever IR-FDPs could present a practical solution for addressing posterior tooth loss, especially in cases where implant placement is not recommended and conventional fixed dental prostheses entail excessive invasiveness.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - João Paulo M Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, LA 1081, The Netherlands
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt; Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Kasem AT, Elsherbiny AA, Abo-Madina M, Tribst JPM, Al-Zordk W. Biomechanical behavior of posterior metal-free cantilever fixed dental prostheses: effect of material and retainer design. Clin Oral Investig 2023; 27:2109-2123. [PMID: 36456895 PMCID: PMC10160170 DOI: 10.1007/s00784-022-04813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To study the fracture resistance and stress distribution pattern of translucent zirconia and fiber-reinforced composite cantilever resin-bonded fixed dental prostheses (RPFDPs) with two retainer designs. MATERIALS AND METHODS Forty human mandibular molars were divided into two groups according to the retainer design. The restorations included a premolar pontic and 2 retainer designs: (D1) inlay ring retainer and (D2) lingual coverage retainer. Each main group was then divided according to the material used (n = 10): zirconia (Z) or fiber-reinforced composite (FRC) (F). Restorations were cemented using dual polymerizing adhesive luting resin. All specimens were thermo-cycled (5-55 °C for 10,000 cycles), then subjected to dynamic loading (50 N, 240,000, and 1.6 Hz) and fracture resistance test. The finite element analysis includes the two models of retainer designs used in the in vitro test. Modified von Mises stress values on enamel, dentin, luting resin, and restorations were examined when the restorations failed. RESULTS A significantly higher failure load was recorded for zirconia groups (505.00 ± 61.50 and 548.00 ± 75.63 N for D1Z and D2Z, respectively) than for FRC groups (345.00 ± 42.33 and 375.10 ± 53.62 N for D1F and D2F, respectively) (P = 0.001). With regard to failure mode, D2 showed a more favorable failure pattern than D1. Model D2 resulted in lower stresses in tooth structure than model D1, and zirconia transmitted more stresses to the tooth structure than FRC. CONCLUSIONS The lingual coverage retainer (D2) enhanced the biomechanical performance of the restoration/tooth complex. Considering the failure mode and tooth stress, FRC is a promising treatment option when constructing a cantilever RPFDP. CLINICAL RELEVANCE Dentists should be aware of the biomechanical behavior during the selection of the material and for the replacement of a single missing mandibular premolar tooth with minimally invasive RBFDP.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit Van Amsterdam and Vrije Universiteit, Amsterdam, Noord-Holland, the Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Kasem AT, Elsherbiny AA, Abo-Madina M, Tribst JPM, Al-Zordk W. Effect of different designs of minimally invasive cantilever resin-bonded fixed dental prostheses replacing mandibular premolar: Long-term fracture load and 3D finite element analysis. J Prosthodont 2023; 32:e41-e51. [PMID: 36502276 DOI: 10.1111/jopr.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/24/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the fracture load and stress magnitude of different retainer designs of minimally invasive cantilever resin-bonded fixed dental prostheses (RBFDPs) after artificial aging. MATERIALS AND METHODS Fifty caries-free human mandibular molars were prepared as abutments for cantilever fixed dental prostheses using different retainer designs: one wing (OW), two wings (TW), inlay ring (IR), lingual coverage (LC), and occlusal coverage (OC). Computer-aided design and computer-aided manufacturing were used for milling the RBFDPs using fiber-reinforced composite (FRC), and the restorations were adhesively bonded. The specimens were then subjected to thermomechanical aging and loaded until failure. The 3D finite element analysis (FEA) was performed with five models of retainer designs similar to the in vitro test. Modified von Mises stress values on enamel, dentine, luting resin, and restorations were examined. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (p < 0.001). RESULTS A statistically significant difference (p < 0.001) was found between all groups except between IR and LC and between OW and TW designs, with the highest mean failure load detected for OC (534.70 N) and the lowest detected for OW (129.80 N). With regard to failure mode, OW, TW, and LC showed more incidences of favorable failure patterns than IR and OC designs. FEA showed that FRC transmitted low stresses in tooth structure and high stresses to the luting resin. CONCLUSIONS LC and OC designs can be used to design cantilever RBFDPs in premolar area. IR design transmitted more stresses to the tooth structure and resulted in 30% catastrophic failure. OW and TW were below the normal occlusal force and should be carefully used.
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Affiliation(s)
- Ammar T Kasem
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Manal Abo-Madina
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.,Fixed Prosthodontics Department, Faculty of Dentistry, Delta University for Science and Technology, Mansoura, Egypt
| | - João Paulo M Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Walid Al-Zordk
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Osman MLM, Lim TW, Chang HC, Ab Ghani AR, Tsoi JKH, Ab Ghani SM. Structural Integrity of Anterior Ceramic Resin-Bonded Fixed Partial Denture: A Finite Element Analysis Study. J Funct Biomater 2023; 14:jfb14020108. [PMID: 36826907 PMCID: PMC9962904 DOI: 10.3390/jfb14020108] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
This study was conducted as a means to evaluate the stress distribution patterns of anterior ceramic resin-bonded fixed partial dentures derived from different materials and numerous connector designs that had various loading conditions imposed onto them through the utilization of the finite element method. A finite element model was established on the basis of the cone beam computed tomography image of a cantilevered resin-bonded fixed partial denture with a central incisor as an abutment and a lateral incisor as a pontic. Sixteen finite element models representing different conditions were simulated with lithium disilicate and zirconia. Connector height, width, and shape were set as the geometric parameters. Static loads of 100 N, 150 N, and 200 N were applied at 45 degrees to the pontic. The maximum equivalent stress values obtained for all finite element models were compared with the ultimate strengths of their materials. Higher load exhibited greater maximum equivalent stress in both materials, regardless of the connector width and shape. Loadings of 200 N and 150 N that were correspondingly simulated on lithium disilicate prostheses of all shapes and dimensions resulted in connector fractures. On the contrary, loadings of 200 N, 150 N, and 100 N with rectangular-shaped connectors correspondingly simulated on zirconia were able to withstand the loads. However, two of the trapezoidal-shaped zirconia connectors were unable to withstand the loads and resulted in fractures. It can be deduced that material type, shape, and connector dimensions concurrently influenced the integrity of the bridge.
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Affiliation(s)
- Mas Linda Mohd Osman
- Centre of Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Tong Wah Lim
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hung-Chih Chang
- Department of Biomedical Engineering, Hungkuang University, Taichung City 433304, Taiwan
| | - Amir Radzi Ab Ghani
- College of Engineering, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| | - James Kit Hon Tsoi
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Siti Mariam Ab Ghani
- Centre of Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- Correspondence: ; Tel.: +86-603-61266611
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Yoshino K, Ito K, Kuroda M, Sugihara N. Survival Rate of 3-unit Fixed Partial Dentures Replacing First Molars: A Retrospective Cohort Study. THE BULLETIN OF TOKYO DENTAL COLLEGE 2023; 63:159-165. [PMID: 36384758 DOI: 10.2209/tdcpublication.2022-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Fixed partial dentures (FPDs) made of 12% Au-Pd alloy are covered under Japan's national health insurance system. The survival rate of such 3-unit fixed FPDs remains unknown, however. The purpose of this retrospective study was to assess their survival rate in the replacement of first molars. A total of 140 FPDs were included, and the endpoint was removal of an FPD. During the observation period, 43 FPDs were removed. The FPD survival rate was 70.2% at 10 yr, 58.2% at 15 yr, and 42.1% at 20 yr according to the Kaplan-Meier method. The estimated mean survival period was 19.4 yr. The main reasons for FPD loss were dental caries (27.9%), separation from the abutment tooth (18.6%), and pulpitis (18.6%). Single factor analysis using the log-rank test showed that two factors influenced FPD survival: a smaller gonial angle and deep pockets around the abutment teeth. This effect was not statistically significant in either case, however (p>0.05). The present results suggest that the prevention of caries and of the separation of the dentures from the abutment teeth are important factors in the long-term survival of FPDs.
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Affiliation(s)
- Koichi Yoshino
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | | | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental College
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Narwani S, Yadav NS, Hazari P, Saxena V, Alzahrani AH, Alamoudi A, Zidane B, Albar NHM, Robaian A, Kishnani S, Somkuwar K, Bhandi S, Srivastava KC, Shrivastava D, Patil S. Comparison of Tensile Bond Strength of Fixed-Fixed Versus Cantilever Single- and Double-Abutted Resin-Bonded Bridges Dental Prosthesis. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5744. [PMID: 36013880 PMCID: PMC9416637 DOI: 10.3390/ma15165744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Resin-bonded fixed dental prostheses (RBFDP) are minimally invasive alternatives to traditional full-coverage fixed partial dentures as they rely on resin cements for retention. This study compared and evaluated the tensile bond strength of three different resin-bonded bridge designs, namely, three-unit fixed-fixed, two-unit cantilever single abutment, and three-unit cantilever double-abutted resin-bonded bridge. Furthermore, the study attempted to compare the tensile bond strengths of the Maryland and Rochette types of resin-bonded bridges. Based on the inclusion and exclusion criteria, a total of seventy-five extracted maxillary incisors were collected and later were mounted on the acrylic blocks. Three distinct resin-bonded metal frameworks were designed: three-unit fixed-fixed (n = 30), two-unit cantilever single abutment (n = 30), and a three-unit cantilever double abutment (n = 30). The main groups were further divided into two subgroups based on the retainer design such as Rochette and Maryland. The different prosthesis designs were cemented to the prepared teeth. Later, abutment preparations were made on all specimens keeping the preparation as minimally invasive and esthetic oriented. Impression of the preparations were made using polyvinyl siloxane impression material, followed by pouring cast using die stone. A U-shaped handle of 1.5 mm diameter sprue wax with a 3 mm hole in between was attached to the occlusal surface of each pattern. The wax patterns were sprued and cast in a cobalt-chromium alloy. The castings were cleaned by sandblasting, followed by finishing and polishing. Lastly, based on the study group, specimens for Rochette bridge were perforated to provide mechanical retention between resin cement and metal, whereas the remaining 15 specimens were sandblasted on the palatal side to provide mechanical retention (Maryland bridge). In order to evaluate the tensile bond strength, the specimens were subjected to tensile forces on a universal testing machine with a uniform crosshead speed. The fixed-fixed partial prosthesis proved superior to both cantilever designs, whereas the single abutment cantilever design showed the lowest tensile bond strength. Maryland bridges uniformly showed higher bond strengths across all framework designs. Within the limitations of this study, the three-unit fixed-fixed design and Maryland bridges had greater bond strengths, implying that they may demonstrate lower clinical failure than cantilever designs and Rochette bridges.
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Affiliation(s)
- Shweta Narwani
- Department of Prosthodontics and Crown & Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal 462037, India
| | - Naveen S. Yadav
- Department of Prosthodontics and Crown & Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal 462037, India
| | - Puja Hazari
- Department of Prosthodontics and Crown & Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal 462037, India
| | - Vrinda Saxena
- Department of Public Health Dentistry, Government Dental College, Indore 452001, India
| | | | - Ahmed Alamoudi
- Department of Oral Biology, King Abdulaziz University, Jeddah 80200, Saudi Arabia
| | - Bassam Zidane
- Department of Restorative Dentistry, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | | | - Ali Robaian
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj 16278, Saudi Arabia
| | - Sushil Kishnani
- Department of Conservative Dentistry & Endodontics, Peoples College of Dental Sciences, Peoples University, Bhopal 462037, India
| | - Kirti Somkuwar
- Department of Prosthodontics and Crown & Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal 462037, India
| | - Shilpa Bhandi
- Department of Restorative Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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