In our practice we often provide resin bonded bridge treatment. When indicated it is a great treatment option. In this blog post we would like to answer the most common questions related to resin bonded bridges.
Resin bridge is a type of fixed dental prosthesis
Resin bonded bridge, also called resin retained bridge, is a type of fixed dental prosthesis for the replacement of a single missing tooth. The design of the bonded bridge consists of an artificial tooth with the wing-like extension which is bonded to the neighboring tooth or teeth. The tooth which supports the resin bonded bridge is called an abutment. The tooth which is replaced by the bonded bridge is called a pontic. Usually only minimal preparation is done to the abutment tooth and this treatment is considered minimally invasive. The wing portion of the resin bonded bridge must be bonded to the supporting tooth using strong dental adhesive in order for it to work over the long-term.
Indications and contraindications for resin bonded bridge
Indication for the resin bonded bridges includes replacement of single missing top or bottom front tooth such as incisor or canine. The bonded bridge is not commonly used for the replacement of the missing back tooth due to the higher biting force in the area of back teeth and risk of bridge loosening.
Resin bonded bridges are not recommended in situations where there is no space to accommodate the wing-like extension which covers abutment tooth. For example, a deep bite relationship of the front teeth may preclude placement of the bonded bridge for the top front tooth. Resin bonded bridges are not recommended when the abutment tooth has less than ideal structure, minimal enamel, or bone support. Other options in the replacement of a single missing tooth include dental implants, dental bridges and removable dentures.
Materials for resin bonded bridges
The most common materials used in the production of bonded bridges include ceramics or a combination of ceramic and metal. The all-ceramic approach is chosen when there is high demand in regard to the appearance of the tooth. When we use a combination of metal and ceramic, the wing of the bonded bridge is made out of metal and the missing tooth portion is made in such a way that metal base is covered on ceramic to imitate the appearance of the natural tooth. In some situations, the bonded bridge can also be made out resin (plastic) material.
Bonded bridges in comparison to conventional dental bridges
Bonded bridges are very different from the conventional bridge. Conventional bridges are more invasive as they require reduction of the supporting abutment teeth which results in irreversible loss of tooth enamel. Bonded bridge only requires minimal tooth preparation.
Resin bonded bridge longevity
Treatment with bonded bridges is a technique sensitive procedure. However, when done correctly, dental literature indicates an average longevity of about 5- 10 years.
Different types of bonded bridges
Maryland Bridge is a type of resin bonded bridge where non-precious base metal alloy in combination with ceramic is used for the replacement of missing teeth. This type of design was developed at the University of Maryland.
Two-wing also called two-retainer, or cantilevered bonded bridge imply that two teeth adjacent to the missing tooth provide support to the bridge.
One-wing also called single-retainer bonded bridge or cantilevered bonded bridge is a type of design where only one tooth adjacent to the missing tooth supports the bridge.
One might assume that two-wing design is a better solution since it provides more of the surface area for bonding. However, dental research indicates higher incidence of loosening on one of the teeth in case of the two-wing design. This is potentially a problem since space under the loose wing cannot be easily cleaned and a cavity can develop under the wing. For this reason, one-wing design is the most common option performed today.
Treatment process with bonded bridges
Treatment with bonded bridges consist of several steps and usually can be delivered over several appointments with minimal discomfort to the patient. Initial diagnostic stage involved clinical evaluation with addition of photographs, x-rays and dental models. This information is used in the production of treatment plan and necessary preparations which may be dictated by the clinical case. On some occasions, patients may be advised to have orthodontic or gum graft procedures and this treatment may delay overall treatment time.
The next step of treatment involves tooth preparation and mold taking using dental impressions or a dental scanner. The obtained information is sent to the dental laboratory where the bonded bridge is designed and fabricated.
The last clinical appointment involves bonding of the bridge with resin adhesive. This is an extremely important procedure for the long term performance of the bridge. The abutment tooth and surface of the bridge is roughened using sandblasting and chemical etching. The bridge is than bonded to the tooth with the help of a strong dental adhesive.
Maintenance requirements of the resin bonded bridges
Maintenance of the bonded bridge is a relatively straightforward process. Patients are commonly advised to clean around the bridge using regular and inter-proximal brushes as well as flossing. Bridges are also monitored on a regular basis during periodic checkup appointments.
Cost of resin bonded bridge treatment
Resin bonded bridges are less expensive in comparison to other treatment alternatives. It is similar to the cost of the dental bridge and much less expensive than the dental implant treatment.