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Use of carbon-epoxy frameworks for reinforcing provisional fixed partial dentures.

This article describes a technique for reinforcing provisional fixed partial dentures. Solid carbon-epoxy rods were shaped and coated with opaque resin to strengthen them for PMMA restorations of 3 or more units with at least 1 pontic. Because of the rigid nature of the prepolymerized carbon-epoxy material, only straight fixed partial dentures can be fabricated with this technique that allows for simplified fabrication of reinforced metal-free and cost-effective restorations.

Carbon↗

A technique for fabrication of a provisional fixed partial denture for nonparallel abutments.

A satisfactory provisional fixed partial denture (FPD) should provide positional stability, maintain the occlusion, and place an additional load on the abutments so that if sensitivity develops, it will subside before the insertion of the definitive FPD. This article presents a technique using an indirect-direct procedure for the fabrication of a 2-part provisional FPD, utilizing a commercially available stainless steel wrought-wire clasp with an occlusal rest, which fulfills all the requirements of a provisional FPD.

Crowns↗

Chairside prefabricated fiber-reinforced resin composite fixed partial dentures.

The introduction of pre-impregnated fiber-reinforced resin composites has provided the dental profession with the opportunity to fabricate and deliver adhesive, esthetic, and metal-free tooth replacements. Utilizing this technology, a prefabricated fiber-reinforced resin composite fixed partial denture prototype that allows rapid, cost-effective, and noninvasive fixed tooth replacement for single anterior teeth has been developed. Ideal situations for this type of service include: a fixed replacement following tooth loss from trauma; a fixed tooth replacement in medically compromised patients who cannot sit for extended periods of time or have local anesthesia; periodontally compromised abutments; a fixed space maintainer following orthodontic movement; and a fixed provisional during the post implant healing phase prior to loading. This article describes the framework construction and placement protocol for the prefabricated fiber-reinforced resin composite fixed partial denture.

Composite Resins↗

The effect of box preparation on the strength of glass fiber-reinforced composite inlay-retained fixed partial dentures.

STATEMENT OF PROBLEM: Nonstandardized box dimensions for inlay-retained fixed partial dentures (FPDs) may result in uneven distribution of the forces on the connector region of such restorations. PURPOSE: The objective of this in vitro study was to evaluate the effect of box dimensions on the initial and final failure strength of inlay-retained fiber-reinforced composite (FRC) FPDs. MATERIAL AND METHODS: Twenty-one inlay-retained FPDs were prepared using FRC (everStick) frameworks with unidirectional fiber reinforcement between mandibular first premolars and first molars. Boxes were prepared using conventional inlay burs (Cerinlay), and small and large ultrasonic tips (SONICSYS approx). Box dimensions were measured after preparation with a digital micrometer. All restorations were subjected to thermal cycling (6000 cycles, 5 degrees C-55 degrees C). Fracture testing was performed in a universal testing machine (1 mm/min). Acoustic emission signals were monitored during loading of the specimens. Initial and final fracture strength values (2-way ANOVA, Bonferroni post hoc tests, alpha =.05) and failure types (Fisher exact test) were statistically compared for each group. RESULTS: Significant differences (P =.0146 and P =.0086) were observed between the groups in the dimensions of the boxes prepared using conventional burs buccolingually (2.8-3.0 mm in molars, 3.1-4.3 mm in premolars) and the small size (2.5-2.9, 2.9-3.8 mm) or large size (2.6-3.8, 3.2-4.9 mm) ultrasonic tips for the premolars and the molars, respectively. No significant differences were found at the initial and final failures between the conventionally prepared group (842 +/- 267 N, 1161 +/- 428 N) and those prepared with either small (1088 +/- 381 N, 1320 +/- 380 N) or large ultrasonic tips (1070 +/- 280 N, 1557 +/- 321 N), respectively. The failure analysis demonstrated no significant difference in failure types but predominant delamination of the veneering resin (85%) in all experimental groups. According to acoustic emission tests, a higher energy level was required for final failure of the FRC FPDs with boxes finished using small ultrasonic tips. CONCLUSION: Standardized box dimensions showed no significant effect on fracture strength at either initial or final failure of the fiber-reinforced FPDs. The FRC FPDs with boxes refined with small ultrasonic burs required a greater energy level before failure. The type of failure observed after the fracture tests was primarily delamination of the veneering resin.

Acoustics↗

Comparisons of tactile thresholds between implant-supported fixed partial dentures and removable partial dentures.

This study compared the tactile sensitivity of splinted abutment and denture teeth of 16 fixed partial dentures (FPD) supported by blade implants and 16 removable partial dentures (RPD) in patients with Kennedy Class I and Class II edentulous conditions. No significant differences were noted between the tactile thresholds of the natural abutment teeth and artificial teeth in the FPD and RPD groups. The splinted abutment teeth required 45.4 g, or 5.4 to 5.8 times higher occlusal loads than did those needed for the comparable nonsplinted teeth, to detect the stimulus. A further increase of 54% in thresholds with the FPD and over 100% with the placement of the RPD indicated the superiority of the RPD in terms of load distribution as a result of the cross-arch splinting and mucosal support. Moderate positive correlations (r = 0.37 to 0.46; P < .05) between tactile thresholds and masticatory performance were found, signifying that reduced tactile perception was not responsible for the incomplete restoration of the masticatory function with RPDs or FPDs but might be contributing to increased masticatory performance within both treatment groups.

Analysis of Variance↗

Fixed partial dentures opposing complete dentures.

When fixed partial dentures are indicated in an arch opposing a complete denture, it is best to develop the occlusal surfaces of the fixed restorations at the same time that the opposing denture teeth are arranged in wax to permit greater flexibility and reduce the compromise in developing bilateral balanced occlusion. This article describes the development of bilaterally balanced occlusion between casting patterns for fixed partial dentures and a complete denture. The technique emulates the ease of arranging maxillary and mandibular denture teeth and can be used to develop fixed restorations with metal or porcelain occlusal surfaces. Porcelain occlusal surfaces are described because the use of porcelain is more technique sensitive.

Acrylic Resins↗

Cement failure loads of 4 provisional luting agents used for the cementation of implant-supported fixed partial dentures.

The major disadvantage of cement-retained implant-supported fixed partial dentures (FPDs) is difficulty in retrievability. The retentive strengths of the provisional luting agents usually employed in these cases are therefore an important consideration. This study evaluated the cement failure loads of 4 provisional luting agents used for the cementation of FPDs supported by 2 implants or 4 implants. Nogenol luting agent exhibited the lowest retentive values in both types of FPD. ImProv proved to be the most retentive cement of all tested. Temp Bond NE and Temp Bond presented significantly different values (P < .05) for the 2-implant FPD, but not for the 4-implant model. On the basis of the study results, it may be concluded that Nogenol appears to be more appropriate for cementation of both 2- and 4-implant-supported FPDs when removal of the provisionally cemented superstructure is anticipated.

Analysis of Variance↗

Cement-retained implant-supported fixed partial dentures: a 6-month to 3-year follow-up.

This study presents a follow-up of 92 implant-supported fixed partial dentures that have been cement retained for 6 months up to 3 years. Included in the study were 41 women and 29 men. A total of 225 implants were placed (86 in the maxilla and 139 in the mandible). Fixed partial dentures, including single-tooth restorations, were temporarily cemented using Temp-Bond or IRM. Complications encountered were cement washout, procelain fracture, loose central screws, and implant failure. This study suggests an alternative to screw-retained prostheses; the method presented may lower the reported complications.

Adult↗

A 5-year longitudinal study of cantilevered fixed partial dentures compared with removable partial dentures in a geriatric population.

Prosthesis function and dental conditions were observed for 5 years in 27 elderly patients treated with mandibular cantilevered fixed partial dentures (FPDs) and in 26 elderly patients treated with distal-extension removal partial dentures (RPDs). All patients were treated with a complete upper denture. The patients were assigned randomly into two treatment groups that had the same composition with regard to sex, age, and distribution of teeth. The patients were under supervised oral hygiene and prosthodontic care. Clinical examination of prostheses, masticatory system, periodontal status, and caries was carried out yearly. Oral hygiene was good, and the periodontal status was maintained in both groups. Caries was observed six times more frequently in the RPD group than in the group with fixed restorations, however. Occlusal and functional conditions deteriorated in the RPD group only. Eight of 42 fixed partial dentures (19%) failed; of these, six were recemented with composite resin. Generally the need for dental and prosthetic follow-up treatment was more pronounced in the RPD group than in the FPD group.

Aged↗

A new design for all-ceramic inlay-retained fixed partial dentures: a report of 2 cases.

In a previous clinical study, all-ceramic resin-bonded 3-unit inlay-retained fixed partial dentures (IRFPDs) had a significantly worse outcome in the posterior region than did crown-retained 3-unit FPDs made from the same material. Debonding or fractures were causes of failure. To improve the clinical outcome of IRFPDs, a new framework design was developed: (1) The inlay retainers were made out of CAD/CAM-manufactured zirconia ceramic to improve fracture resistance, and additional veneering of the inlays was omitted. (2) The inlay retainers were completed with a shallow occlusal inlay (1-mm minimum thickness) and an oral retainer wing (0.6-mm minimum thickness). The wings were designed to reduce stress on the inlay retainer caused by torsion forces when the FPD is loaded nonaxially and to increase the enamel adhesive surface area. The pontic was circumferentially veneered with feldspathic porcelain. The clinical and laboratory procedures of this new treatment modality are described, and 2 exemplary clinical cases are presented. This new preparation and framework design might improve the clinical outcome of all-ceramic resin-bonded IRFPDs. However, adequate evidence of long-term safety and efficacy is required before this new design can be recommended for general clinical practice.

Adult↗

Veterans Administration Cooperative Dental Implant Study--comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part IV: Comparisons of patient satisfaction between two treatment modalities.

This study compares treatment assessments made by two groups of patients with Kennedy class I or class II mandibular edentulous conditions, who received either a removable partial denture (RPD) (N = 115) or one or two fixed partial dentures (FPDs), each supported distally by a blade implant (N = 113). Two questionnaires were administered, one at 16 weeks after the implant or RPD insertion and at the 6-month interval and the other at 18, 36, and 60 months. Marked functional improvements were perceived by a large majority of patients in both groups after the insertion of prosthesis. At 6 months, a higher percent of patients with RPDs than those with FPDs found it easy to clean their RPDs and experienced chewing discomfort, restriction of food choices, feeling of insecurity with their RPDs, and difficulty with their pronunciation. The exclusion of assessments by 25 RPD patients, whose treatment was judged to be a failure functionally, made the mean differences between the two treatments statistically significant (p less than 0.05) only for ease of cleaning in favor of the RPD and fewer restrictions of food choices in favor of the FPD group. At 60 months, significant differences between the percents of patients with the most favorable responses occurred for perceptions of eating enjoyment, food particles seldom getting under the removable partial denture, and improvement in social life in favor of the FPD treatment and for the ease of cleaning the removable partial denture in favor of the RPD treatment. The results seem to support superiority of the FPD in terms of patient satisfaction, but not enough to favor this type of prosthesis over the RPD without consideration of other pertinent factors.

Adaptation, Psychological↗

An implant-supported, screw-retained, provisional fixed partial denture for pontic site enhancement.

Due to remodeling of the edentulous ridge following tooth extraction, clinicians and dental technicians face a variety of challenges when attempting to deliver an aesthetic fixed partial denture for the anterior maxilla. An implant-supported, screw-retained fixed partial denture provisional restoration can be utilized in order to manipulate the pontic site with predictable success. This technique can create the illusion of pontics emerging from the soft tissue, creating a natural-looking effect for seating of the definitive restoration.

Dental Abutments↗

A procedure for fitting a fixed partial denture to an existing removable partial denture.

An indirect technique for fitting a new cast gold crown or fixed partial denture (FPD) to an existing removable partial denture (RPD) is presented. This method uses an acrylic resin coping made on a definitive cast fit directly to the patient's RPD intraorally, with the new FPD subsequently completed on the cast. The patient does not have to relinquish the RPD for laboratory procedures, although an appointment is required to fit the coping intraorally where contact is made with the RPD.

Crowns↗

Use of a multifunctional precision attachment in a fixed partial denture with limited periodontal support. A clinical report.

A multifunctional precision attachment used in a fixed partial denture with questionable prognosis enhances the serviceability of the reconstruction. In the treatment presented, future loss of the posterior abutments will not jeopardize the complete rehabilitation. Osseointegrated implants used in conjunction with a fixed prosthesis or a removable partial denture can restore the missing segments.

Cuspid↗

In vitro resistance of reinforced interim fixed partial dentures.

STATEMENT OF PROBLEM: Comprehensive restorative dental treatment often necessitates the use of interim fixed partial dentures (FPDs) with high stiffness, especially in long-span restorations or areas of heavy occlusal stress. PURPOSE: This in vitro study evaluated the fracture load of interim FPDs made with various materials and span lengths. MATERIAL AND METHODS: Groups (n = 3) of interim FPDs were fabricated with prosthodontic resin materials on 2 abutments with 3 different pontic widths of 3 units (12 mm), 4 units (19 mm), and 5 units (30 mm). The following materials were tested: (1) a thermoplastic polymer (Promysan Star), (2) Promysan Star with a veneering composite (Vita Zeta), (3) a nonimpregnated polyethylene fiber reinforced resin (Ribbond) with a veneering composite (Sinfony), (4) an impregnated fiber reinforced composite system (Targis/Vectris), and (5) a conventional polymethyl methacrylate, Biodent K+B, (control group). After 5000 thermocycles in 2 water baths at 5 degrees and 55 degrees C, the FPDs were temporarily fixed with a provisional cement on the corresponding abutments and subjected to 3-point bending until fracture by a universal testing machine. Statistical analysis consisted of an analysis of variance (ANOVA, 1-way, 2-way) and Bonferroni-Dunn's multiple comparisons post hoc analysis for test groups (alpha = .05). RESULTS: Fracture resistance (N) differed significantly for 3 (mean: 640 +/- 146 N), 4 (626 +/- 229 N), and 5 unit (658 +/- 98 N) Targis/Vectris FPDs compared with the corresponding Promysan (284 +/- 21 N to 125 +/- 73 N), Biodent K+B (247 +/- 91 N to 218 +/- 85 N), and Promysan/Vita Zeta (95 +/- 15 N to 82 +/- 6 N) groups (P < .05). Significant differences were obtained for the 4 and 5 unit Targis/Vectris FPDs compared with the Sinfony/Ribbond FPDs (281 +/- 25 N - 252 +/- 74 N) for the corresponding pontic spans. CONCLUSION: Within the limitations of this in vitro study the impregnated fiber reinforcement may considerably enhanced the fracture resistance of interim FPDs of different span lengths.

Analysis of Variance↗

The effect of carbon graphite fiber reinforcement on the strength of provisional crown and fixed partial denture resins.

This study compared the moduli of elasticity of three provisional crown and fixed partial denture resins. Eighteen specimens of each resin were reinforced with carbon graphite fibers and 18 resin specimens from each group contained no fibers. Six specimens of each resin, with and without fibers, were tested within 6 hours of fabrication, after 30 days, and after 60 days of water storage. The mean moduli of elasticity of all the resins increased significantly with fiber incorporation. Water storage did not have a significant effect on the moduli of elasticity of the resins tested.

Acrylic Resins↗

Clinical performance and periodontal outcome of temporary crowns and fixed partial dentures: A randomized clinical trial.

STATEMENT OF PROBLEM: Different materials (autopolymerizing, dual curing, and light initiated) are used for fabricating provisional restorations during prosthetic treatment. Randomized clinical trials that have evaluated these provisional materials have not been published. PURPOSE: This clinical trial compared the handling, fitting, plaque adherence, gingivitis, color stability, and the subjective assessment of the provisional materials by the patient and the dentist for 2 autopolymerizing (Protemp, Luxatemp), 1 dual-curing (Provipont), and 1 light-initiated (Triad-VLC) material for the manufacturing of temporary crowns and fixed partial dentures. MATERIAL AND METHODS: Thirty subjects in need of 2 similar fixed prosthetic restorations (single crowns ¿20, three-quarter crowns ¿2, connected crowns ¿9, or fixed partial dentures ¿30) were treated with 1 temporary restoration of Protemp II (control) and one randomly selected from Luxatemp, Provipont, or Triad-VLC materials. The mean time of treatment was 37.5 days (minimum 2 days, maximum 156 days). All restorations were manufactured intraorally with a vacuum-formed template. RESULTS: Mechanical and retentive characteristics revealed a high level of clinical reliability. Plaque adherence of the teeth with temporary restorations was significantly increased (P =.0039) compared with the untreated mesial reference teeth. CONCLUSION: The advantageous mechanical properties of the light-curing and dual-curing materials reviewed in dental literature were clinically offset by disadvantages in handling.

Chi-Square Distribution↗

A provisional fixed partial denture that simulates gingival tissue at the pontic-site defect.

A technique is presented for the fabrication of an esthetic, provisional fixed partial denture that compensates for a pontic-site ridge defect. This provisional restoration enables both the dentist and the patient to evaluate whether this prosthetic approach will adequately camouflage the pontic-site defect or whether surgical correction of the pontic site should also be considered.

Acrylic Resins↗