Immediate tooth replacement using fiber-reinforced composite and natural tooth pontic

Natural Tooth Pontic Using Recent Adhesive Technologies: An Esthetic and Minimally Invasive Prosthetic Solution

An implant-supported crown represents an established and validated option for single-tooth replacement; however, a restorative solution should be selected according to a wide number of factors including patient's desire, expectations, specific clinical conditions, and financial possibilities. The aim of this case report is to describe a conservative rehabilitation strategy for the replacement of a periodontally compromised mandibular incisor: the extracted natural tooth was used as a pontic bonded to adjacent elements with polyethylene fiber and resin composite. This way, a chairside fabrication of a resin-bonded fiber-reinforced prosthesis is possible, using the patient's own tooth. After showing a satisfactory functional and esthetic result, advantages and pitfalls of this technique along with available data on the literature regarding the natural tooth pontic are addressed. Both patients and clinicians should be aware of minimally invasive, successful solutions for single-tooth replacement; whether indicated or necessary, the natural tooth pontic technique leaves open other treatment options for the future.

Fiber-reinforced composite resin bridges: an alternative method to treat root-fractured teeth

The replacement of missing teeth, especially in the anterior region, is an essential part of dental practice. Fiber-reinforced composite resin bridges are a conservative alternative to conventional fixed dental prostheses or implants. It is a minimally invasive, reversible technique that can be completed in a single visit. The two cases presented herein exemplify the treatment of root-fractured anterior teeth with a natural pontic immediately after extraction.

Retrospective study of combined splinting restorations in the aesthetic zone of periodontal patients

Evaluates the clinical performance of of a fiber-reinforced, composite-resin bonded splint; a bridge; a fiber post; and/or a resin veneer for the restoration of periodontally-involved anterior teeth.

Shows that a combination of approaches is a good choice for minimally invasive prosthodontic treatment in the aesthetic zone in periodontal patients.

Aims This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth.

Methods Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured.

Results All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p <0.05), and subsequently increased to 3.5±1.0 mm again after four years (p >0.05). These changes were similar to those in the mean CAL.

Conclusion A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients.

A Novel Approach to Regain Anterior Space Using Modified 2 by 3 Fixed Appliance: A Report of Two Cases

Early loss of permanent anterior teeth in growing children has a psychological impact on the child. Anterior teeth are important both aesthetically and functionally. When a permanent tooth is lost, the teeth adjacent to the created space tend to migrate into the space resulting in the space loss. Management of regaining space with the removable appliance always depends on child cooperation for using the appliance as well as for the recall visits. The advantages of fixed appliances over the removable appliances are minimal discomfort, reduced need for patient cooperation and increased control of tooth movements in all three directions of space. Thus, a short course of fixed appliance like the modified 2 by 3 fixed appliance followed by fixed functional space maintainer could be an ideal treatment option for such cases.

Esthetic rehabilitation of single anterior edentulous space using fiber-reinforced composite

A fiber-reinforced composite (FRC) fixed prosthesis is an innovative alternative to a traditional metal restoration, as it is a conservative treatment method. This case report demonstrates a detailed procedure for restoring a missing anterior tooth with an FRC. A 44-year-old woman visited our department with an avulsed tooth that had fallen out on the previous day and was completely dry. This tooth was replanted, but it failed after one year. A semi-direct technique was used to fabricate a FRC fixed partial prosthesis for its replacement. The FRC framework and the pontic were fabricated using a duplicated cast model and nanofilled composite resin. Later on, interproximal contact, tooth shape, and shade were adjusted at chairside. This technique not only enables the clinician to replace a missing tooth immediately after extraction for minimizing esthetic problems, but it also decreases both tooth reduction and cost.

IPS-Empress II inlay-retained fixed partial denture reinforced with zirconia bar: three-dimensional finite element and in-vitro studies

OBJECTIVE

This study evaluated von Mises stress distribution, flexural strength and interface micrographs of IPS-Empress II (IPS) inlay-retained fixed partial dentures (IRFPD) reinforced with Zirconia bars (Zb).

MATERIALS AND METHODS

In the Finite element analysis, six three-dimensional models of IRFPD were designed using Solid Works 2006. Five models were reinforced with different Zb and a model without Zb was considered as a control. The bridges were loaded by 200 and 500 N forces at the middle of the pontic on the occlusal surface. Subsequently, von Mises stress and displacement of the models were evaluated along a defined path. In the experimental part, 21 bar shape specimens were fabricated from lithium disilicate and zirconia ceramic in three different designs. The zirconia-IPS interfaces and the fractured surfaces of flexural test were observed using SEM.

RESULTS

In the connector area, von Mises stress and displacement of the models with Zb under a load of 500 N were decreased compared to the model without the Zb; however, this difference was not considerable at a load of 200 N. In the mesial connector, Von Mises stress and displacement was decreased from 12.5 Mpa for the control model tested at 500 N to 7.0 Mpa for the model with Zb and from 0.0050-0.0041 mm, respectively. SEM analyses showed that, before fracture, interfacial gaps were not observed along the interfaces, but initiated cracks propagated along the interfaces after flexural loading.

CONCLUSION

IPS IRFPD reinforced by Zb can tolerate higher stresses while still functioning effectively and the interfaces may have desirable adaption.