Influence of the amount of tooth surface preparation on the shear bond strength of zirconia cantilever single-retainer resin-bonded fixed partial denture

Biomechanical behavior of posterior metal-free cantilever fixed dental prostheses: effect of material and retainer design

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.

Patient with Poor Esthetic Anterior Tooth Position Treated with Lithium Disilicate Mesial Cantilever Single-retainer Fixed Partial Denture: A Case Report

We report a case of fixed prosthetic treatment for poor esthetics due to the position of the maxillary left lateral incisor in a 43-year-old woman. Initial examination revealed no carious lesions, but the tooth axis of the maxillary right canine showed mesial inclination of approximately 15°. Orthodontic treatment was first proposed but was declined by the patient as they did not wish to undergo a prolonged period of therapy. Therefore, recovery by extraction of the maxillary right lateral incisor and prosthetic treatment was proposed as an alternative. The method to be used for application of a 3-unit fixed partial denture and implant treatment was explained to the patient. She refused to give consent to this plan as well, however, due to concerns regarding the need to cut a lot from a non-problematic tooth and the length of time such treatment would require. Therefore, the problem was finally treated by application of a cantilever single-retainer fixed partial denture while giving sufficient consideration to extraction and occlusal contact. Lithium disilicate was used for the material of the prothesis. At 1 year after completion of treatment, no problem was observed with either the prosthetic appliance or the abutment teeth.