Wednesday, November 3, 2010

Anterior Fiber-reinforced Composite Resin Bridge: A Case Report

Resident’s Name: Jessica Wilson

Program: Lutheran Medical Center - Providence

Article title: Anterior Fiber-reinforced Composite Resin Bridge: A Case Report

Author(s): Chafaie & Portier.

Journal: Pediatric Dentistry

Year. Volume (number). Page #’s: 2004. 26:6. 530-534.

Major topic: Treatment of missing incisors

Overview of method of research: Case Report

Purpose:
To present a clinical case of a single tooth replacement by means of a polyethylene FRC bridge.

Background:
Implants are generally not intended before the end of the growth period around 18 years of age and are expensive.
RPD are often used in very young children when adjacent teeth are not in final correct position, but are often not esthetic.
A plastic tooth can be bonded to orthodontic appliances when a child is missing an anterior tooth and in ortho treatment.
A PFM bridge is the most invasive treatment option and can lead to unaesthetic results as can a traditional Maryland bridge with a metal framework.

Methods:
16 year old male referred from orthodontist to Pediatric Dept. in Marseille University in France 1 month after ortho treatment completion. The patient lost #8 due to trauma at 12 years old and had been using a removable appliance with a plastic tooth which had been repaired on several occasions since then. The patient asked for a more esthetic and comfortable treatment.
The patient presented with minimal overbite so no tooth reduction was necessary. A short-span alginate impression was taken in order to reduce tension and provide a more accurate result. Polyvinylsiloxane die material was used to pour the impression up. Length measurement was done by flattening dead soft foil from the middle thirds of each abutment crossing the pontic area directly under the incisal edge. Polyethylene plasma-treated fiber system (Ribbond) was used for the bridge framework. The operator made sure to avoid handling the Ribbond with fingers until it was wetted with bonding agent.

Findings:
Indirect technique provides a better adaption, better polymerization and smoothness compared to the direct technique where excess composite tends to collect in the embrasures.
By using fast-setting silicone die material, the procedure can be done easily chair side and the elasticity of the model allows easy removal of the FRC bridge.
Compared to the traditional metal framework, the FRC bridge is more esthetic with no dark shadow and easier to bond.

Key points/Summary:
FRC bridge is a new hygienic and non-irritating treatment option that generally requires no tooth preparation and can be considered permanent or a long-lasting provisional.

Assessment of Article:
I had never heard of this technique before and found it very pertinent and interesting. Would have liked to see some follow-up, but I’d love to try it!

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