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Numerous designs for posterior resin-bonded fixed partial dentures have been reported in the dental literature, but a methodical technique is still lacking. A groove, plate, and strut approach involving minimal preparation of posterior abutments to receive a resin-bonded fixed partial dentures is presented. The essential clinical and laboratory procedures are illustrated.
STATEMENT OF PROBLEM: Few estimates of the probability of various outcomes associated with replacement of missing teeth with fixed partial dentures have been reported. Existing longitudinal studies have reported widely disparate results for the survival of fixed partial dentures, but these studies have used different definitions of failure and varying periods of follow-up. PURPOSE: This study used meta-analysis to formulate annual probability estimates for three categories of fixed partial denture or abutment survival. METHODS: A systematic review of the English language literature since 1960 identified eight studies that met the preset inclusion criteria. Estimated annual survival proportions were back-calculated based on the Kaplan-Meier model and these proportions were combined through a fixed effects model meta-analysis. The probabilities and corresponding 95% confidence intervals at 5, 10, and 15 years for the three categories of survival are reported. RESULTS: For the aggregate population represented by the limited longitudinal studies available, this meta-analysis indicated that less than 15% of fixed partial dentures were removed or in need of replacement at 10 years; whereas, nearly one third were removed or in need of replacement at 15 years. Less than 5% of abutments were removed at 10 years.
A case of a collarless metal ceramic fixed partial denture with preparations made at a slightly supragingival level is reported. The absence of the metal collar in the buccal portion of the abutments provides an excellent esthetic appearance. The use of a collarless metal ceramic fixed partial denture is a viable approach for restoring dentition where the esthetic quality is the primary concern.
In the present study two-dimensional finite element models of two- and three-unit cantilever fixed partial dentures were created to simulate the replacement of a maxillary second premolar in a shortened dental arch. The purpose of the study was to investigate the mechanical behaviour of the two designs of fixed partial denture using the finite element method. The results indicate that the mechanical behaviour of the three-unit fixed partial denture was more favourable than that of the two-unit fixed partial denture under similar conditions of occlusal loading. Prosthesis displacement and maximum principal stresses increased substantially when loading was limited to the pontic, in particular, in the model of two-unit fixed partial denture.
Adhesively luted all-ceramic inlay-retained fixed partial dentures can be a clinical alternative for the replacement of missing posterior teeth in certain situations. This type of restoration allows satisfactory esthetics and reduced tooth preparation compared to a conventional metal-ceramic fixed restoration. This case report describes the use of an inlay-retained fixed partial denture as a conservative alternative for the replacement of missing posterior teeth.
In logistic regression models, variables were studied for possible influence on the longevity of fixed partial dentures, retainers, and abutments. The type of dental material was the most critical variable for change or removal of fixed partial dentures. Cantilever extension indicated no substantial increased risk of change or removal for the fixed partial dentures. The risk of removal for an abutment was influenced by the following variables: endodontic treatment, distal terminal position, placement in the mandible, and advanced marginal bone loss. Several variables were stronger multivariately than bivariately and this indicated that a combination of risk factors may be the most detrimental for the longevity of the restorations.
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A clinical study was undertaken to review resin-retained fixed partial dentures bonded with a chemically active luting cement during a 4-year period. One hundred thirty-seven fixed partial dentures were reviewed of which five had failed because of a nonbonding failure (esthetics, trauma, fracture) and 47 (36%) had failed after a bonding failure, of which 72% were rebonded. The mean time of failure was 10.9 months (SD 9.8). The failure rate appeared to be affected by position, use of a rubber dam, and the fixed partial denture design, although no one factor reached conventional statistical significance.
Within the limitations of the experiment, the following conclusions can be made from this investigation: 1. Under conditions of vertical loading, the rigid fixed partial denture design does not permit independent response by either abutment. The nonrigid fixed partial denture design allows the abutments some independence in response to vertical loading 2. The stress distributions and concentrations produced in the supporting bone are favorably altered by the placement of a fixed partial denture of rigid or nonrigid design. 3. The distribution of stresses in the supporting bone varies with the number and location of the loading sites. 4. Under conditions of vertical loading, the Ney and Stern nonrigid fixed partial denture designs exhibit no significant differences in stress distribution or concentration.
This study tested the effect of fixed partial dentures on hypermobile abutment teeth with substantially reduced levels of periodontal attachment. One abutment tooth and one control (nonabutment) tooth of the same type and periodontal condition were selected for study in adults. Treatment consisted of periodontal therapy and a 3- or 4-unit fixed partial denture, after which all subjects were placed on a quarterly maintenance schedule. No differences were found between the mean baseline and 24-month measures for all dependent variables at test or control sites.
A 55-year-old man was treated with a glass fibre reinforced composite resin bonded fixed partial denture with an increased bonding surface area. The abutments for replacing two maxillary premolars were not prepared and the bonding surface was expanded to the regions of undercut and the labial/buccal surface of the abutments. This was possible by tailoring the mechanical properties of the fibre reinforced composite frame of the resin-bonded fixed partial denture. Two and half years follow-up demonstrated good clinical success for the restoration. This experience encourages development of non-invasive prosthodontic treatment options for transitional fixed partial denture restorations.
The resin-bonded fixed partial denture has undergone significant changes in design, materials and tooth preparation since its development in 1973. The selection of resin cement and micromechanical retention have closely paralleled alloy-resin-bonding research. Despite impressive in vitro research results, only 74 percent of the prostheses are still functional at the end of four years. Understanding the limitations, indications and design of resin-bonded fixed partial dentures will result in improved longevity and patient satisfaction.
Patients receiving artificial crowns and fixed partial dentures at a prosthodontic clinic were examined 18 to 23 years after treatment. The long-term results were good, especially for the metal ceramic restorations: 79% remained unchanged and only 3% had been removed. The success rate for the gold-resin restorations was less favorable: 43% remained unchanged and 33% had been removed. The use of one cantilever extension unit had not negatively influenced the results for the fixed partial dentures. Generally, those abutment teeth that had been removed during the observation period had received previous endodontic treatment before restorations had been placed. Endodontic complications on abutment teeth were more frequent in the mandible than in the maxillae.
STATEMENT OF PROBLEM: A clinical situation may arise with 2 edentulous spaces and a single intact pier tooth. A dentist may restore these edentulous spaces with a long span resin-bonded fixed partial denture using the pier and the 2 terminal abutments for bonding. PURPOSE: This study analyzed the stresses induced in a pier retainer of an anterior resin-bonded fixed partial denture and determined the effect on a pier abutment. MATERIAL AND METHODS: Photoelastic materials were selected to represent the relative stiffness of 3- and 5-unit resin-bonded fixed partial dentures. The models were scaled to x2.5 to enhance visual analysis of the stress pattern. RESULTS: Isochromatic fringes indicated a stress magnitude at the proximolingual areas of the pontic in the 3-unit resin-bonded fixed partial denture. In the 5-unit resin-bonded prosthesis, the stress pattern appeared to involve the entire surface of the pier retainer. CONCLUSION: The use of pier abutments should be avoided and it is more favorable to use 3-unit resin-bonded fixed partial dentures.
Four types of casting rings were tested for producing accurate-fitting fixed partial dentures. None of the casting rings tested produced ideal results, but the larger oval and round rings produced fixed partial dentures cast as a single unit with more complete seating than those produced in smaller round casting rings when phosphate bonded investment and Type III gold were used. Fixed partial denture seating was affected by the casting ring size but not because of its shape. While distortion of the wax and dimensional change in the gold alloy do affect the seating qualities of castings, this was not statistically significant in this study.
This clinical report describes the construction of a resin-bonded fixed partial denture with a removable pontic during the healing period of a single implant treatment. This design improves maintenance of oral hygiene.
PURPOSE: This study was conducted to assess the quality of impressions and tooth preparations sent to dental laboratories in Jordan and to determine the technical capabilities of these laboratories to construct fixed partial dentures. MATERIALS AND METHODS: A sample of 136 impressions and stone casts were examined for clinical errors in 35 laboratories that construct fixed partial dentures. They were sorted into unusable, unsatisfactory, acceptable, or satisfactory categories. The type of impression material and tray, opposing arch impressions, and occlusal records were noted. Instructions to technicians were assessed for completeness and clarity. Information regarding laboratory staff and equipment were collected. RESULTS: Half of the specimens inspected were categorized as unusable or unsatisfactory; these were found in commercial laboratories. They showed at least one clinical error such as drags or indefinite finishing lines in impressions and inadequate reduction, undercuts, or obvious taper on stone casts. Alginate impression material was used for 65% of the cases. Only 27% of specimens were accompanied with instructions; of these 22% were graded poor. No occlusal records were available with 54% of the specimens and no articulators were used except in dental school laboratories. The dental schools and some commercial laboratories had the best staff and equipment and were more capable of fabricating fixed partial dentures than those of the Ministry of Health and the Royal Med cal Services. CONCLUSION: The quality of abutment preparation and impressions were unsatisfactory or unusable in 50% of cases. Of the 37 available instructions 8 were not clear. The dental schools and some commercial laboratories were technically capable of producing good quality fixed partial dentures.
Twelve patients were followed for 5 years after treatment with a 12-unit cantilever fixed partial denture on the mandibular canines opposed by a complete maxillary denture. Two fixed dentures had to be removed, one because of an abutment tooth root-fracture and one because of rapid marginal bone loss in a terminal stage of leukemia. Caries and periodontal lesions were rare, but other complications, principally related to endodontics, occurred. All complications were amenable to standard treatment procedures. Extensive mandibular cantilever fixed partial dentures may be used in the rehabilitation of patients with a very reduced dentition and a history of difficulties in adapting to removable dentures.