Creating a Single-Visit, Fibre-Reinforced, Composite Resin Bridge by Using a Natural Tooth Pontic: A Viable Alternative to a PFM Bridge

Terminology focused on design and retention methods used for anterior resin-bonded fixed partial dentures in English literature: A scoping review

Purpose

Novel terms describing several designs of resin-bonded fixed partial dentures (RBFPDs) continue to appear. Indeed, a variety of terms are used in the English scientific literature The use of a standard terminology is important for a fair and efficient understanding. This study aimed to investigate if the terminology used to describe designs and retention methods for anterior RBFPDs is standard.

Methods

An electronic search in the English literature was conducted in PubMed/Medline to identify all publications reporting RBFPDs in the anterior region until August 2022. This search was completed by hand searching. Terms indicating different designs of RBFPDs were listed and then classified. Percentages of their use were calculated to determine the commonly used terms. Analysis of the use of these terms was performed based on the standards determined by the latest edition of the Glossary of Prosthodontic Terms (GPT). The impacts of the MeSH Thesaurus and GPT on the nomenclature used for RBFPDs was assessed.

Results

A total of 125 articles were eligible for this review. In the retained articles, 86 terms were found. Among them, thirty-nine terms were classified into three groups. Only six terms were defined in the latest edition of GPT (GPT-9). Several classified terms that are commonly used were not identified in the GPT-9. Conversely to the GPT-9 which impact was insignificant, the MeSH Thesaurus had an important impact on the nomenclature used for RBFPDs.

Conclusion

The terminology used to describe designs and retention methods for anterior RBFPDs was non-standard. The GPT-9, constituting an important reference, defined a limited number of terms related to RBFPDs and had no significant impact on the standardization of the terminology used for RBFPDs. Efforts should therefore be continued to standardize the terminology. A specialized mini-glossary grouping and defining all the terms found in this study will helpful in clarifying the terminology used for the anterior RBFPDs.

Acrylic tooth splint-An immediate provisionalisation following tooth extraction; a series of case reports

Key Clinical Message

Numerous techniques for provisionally replacing a single tooth at the aesthetic zone while planning for future dental implant placement, while soft and hard tissues heal, are critical in restorative treatment strategy. The available materials, simplicity, cost, and impact on the potential implant location should be considered when evaluating the treatment choices.

Abstract

Replacement of a single anterior tooth in the aesthetic zone while planning for future implant placement is crucial to the restorative treatment plan. Several methods exist for immediate provisionalisation of the extracted tooth while waiting for soft and hard tissue healing. Although there's a myriad of possible provisionalisation methods available, each option has its advantages and disadvantages. The treatment options should weigh various factors such as the available materials, ease of fabrication, costs, and the effect on the future implant site. This article describes three clinical cases demonstrating a simple yet cost-effective technique to temporarily replace an extracted single anterior tooth, enhancing patient satisfaction and increasing compliance before receiving the definitive implant restoration. The pro and cons for each treatment option available as opposed to the technique involved in the three cases used are also described.

Reconstruction of Natural Smile and Splinting with Natural Tooth Pontic Fiber-Reinforced Composite Bridge

Teeth replacement is challenging in old patients with severe periodontal disease, limiting prosthetics treatment options. Here, we report a fiber-reinforced composite (FRC) resin bridge using natural tooth pontic in a patient with severe periodontitis. A 60-year-old lady complaining of teeth mobility was diagnosed with severe periodontitis, recession, bone loss, and crowding in the anterior maxillary teeth. Due to a hopeless periodontal prognosis, lateral incisors were extracted and sectioned using a cylindrical diamond bur. The pulp chamber was debrided and filled with self-adhesive flowable composite resin. After three weeks, the pontics were fixed in proximal contact areas, and the FRC bridge was fabricated directly using the resin fiber strip followed by occlusion adjustment, finishing, and polishing. Esthetic, occlusion, and periodontal status were re-evaluated after six months. Here, FRC using natural pontic could successfully reconstruct a natural smile, splint the adjacent teeth, eliminate crowding, and provide stable occlusion. Therefore, this method may be considered for similar cases.

Anterior Tooth Replacement of Avulsed Deciduous Tooth: Resin-Reinforced Fiber With Natural Tooth Pontic

Sudden tooth loss can be a traumatic experience that affects a child psychologically and hampers social skills in today's world, in which appearances seem to matter from a young age. The child becomes afraid to smile freely. Besides appearances, missing anterior teeth can hamper clarity in speech. Many approaches have been described in the past, such as the use of a removable partial denture, functional Nance appliance, Groper's appliance, and resin-reinforced fiber composite/acrylic pontic. We report the case of a child who lost a deciduous tooth as a result of trauma. The restoration was performed using fiber-reinforced resin and a natural avulsed tooth as pontic, which restored esthetics and function.

Fiber reinforced composite supported restoration of congenitally missing tooth by minimally invasive approach: Two years follow-up

Maxillary lateral incisor is the most frequent congenitally missing anterior tooth of the permanent dentition. The absence of the anterior tooth can adversely affect the production/transmission of speech sounds, mental health, and facial aesthetics of an individual. Considering this, prosthetic rehabilitation of missing front tooth is important. The treatment alternatives include implant supported single crown, conventional fixed partial dentures (FPDs), and resin bonded FPDs that are unilaterally or bilaterally supported by metallic wings. However, with the development in adhesive dentistry fiber reinforced composite (FRC) supported FPDs have provided a workable substitute for traditional techniques because of their improved esthetics, minimal invasiveness, less cost, enhanced bond strength, and revocable nature. The current case, reports the two years follow up of twenty-four years old female patient, for whom the congenitally absent maxillary right lateral incisor was restored with FRC supported FPD.

Maintenance of Gingival Profile in the Esthetic Zone using Natural Tooth Pontic

The extraction of periodontally compromised teeth in the anterior esthetic region is a challenging situation due to patients' psychological and esthetic demands. Irrespective of the replacement of missing teeth with the final prosthesis, the first line of management would be to provisionally restore the teeth at the earliest. Routine treatment options for replacement are time-consuming and expensive. Using the patient's natural tooth as a pontic offers the benefits of the same size, shape, color, and preservation of the gingival architecture. Using the patient's platelet concentrate (platelet-rich fibrin) facilitates early wound healing and preservation of the alveolar ridge shape following tooth extraction. With minimal or no preparation, the technique can be completed at the chairside, thereby avoiding laboratory costs. This case report details the procedure with a follow-up of a case where the natural extracted tooth of the patient was used as pontic to replace a missing anterior tooth.

Natural Tooth Pontic: An Instant Esthetic Option for Periodontally Compromised Teeth-A Case Series

Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to trauma, periodontal disease, or endodontic failure. The treatment options for replacing the missing tooth can vary between removable prosthesis, tooth-supported prosthesis, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patient's esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patient's own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. Additionally, using the patient's platelet concentrate (platelet rich fibrin) facilitates early wound healing and preservation of alveolar ridge shape following tooth extraction. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chair side thereby avoiding laboratory costs. This helps the patient better tolerate the effect of tooth loss psychologically. The article describes a successful, immediate, and viable technique for rehabilitation of three different patients requiring replacement of a single periodontally compromised tooth in an esthetic region.

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.