|Year : 2012 | Volume
| Issue : 1 | Page : 51-53
Glass fiber reinforced composite fixed partial denture as provisional tooth replacement in pre-adolescent age: A clinical report
Kaushal Kishor Agrawal, Pooran Chand, Neeraj Mishra, Kamleshwar Singh
Department of Prosthodontics and Dental Material Sciences, F.O.D.S, C.S.M. Medical University, Lucknow, Uttar Pradesh, India
|Date of Web Publication||22-Mar-2012|
Kaushal Kishor Agrawal
Department of Prosthodontics and Dental Material Sciences, F.O.D.S, C.S.M. Medical University, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
The loss of anterior teeth is often a serious esthetic concern. Conventional fixed partial denture and implant-supported restorations may be the treatment of choice although non-impregnated fibers and fiber reinforced composite resins offer a conservative alternative for improved esthetics. This article describes a clinical situation in which non-impregnated fiber glass ribbon and fiber reinforced composite are successfully used to provisionally restore anterior edentulous area in an esthetic, functional and timely manner.
Keywords: Esthetic, fiber reinforced composite resin, pontic
|How to cite this article:|
Agrawal KK, Chand P, Mishra N, Singh K. Glass fiber reinforced composite fixed partial denture as provisional tooth replacement in pre-adolescent age: A clinical report. J Interdiscip Dentistry 2012;2:51-3
|How to cite this URL:|
Agrawal KK, Chand P, Mishra N, Singh K. Glass fiber reinforced composite fixed partial denture as provisional tooth replacement in pre-adolescent age: A clinical report. J Interdiscip Dentistry [serial online] 2012 [cited 2019 Sep 20];2:51-3. Available from: http://www.jidonline.com/text.asp?2012/2/1/51/94195
| Introduction|| |
Traumatic damage to anterior teeth is a common form of injury, particularly in children and adolescents. Patients presenting with traumatized or lost anterior teeth require immediate attention for restoration of esthetics and function. Since wearing of removable appliances is inconvenient to the patient, fixed provisional restoration is a good alternative of choice.
Today, technology allows the opportunity to test new materials for use as provisional replacement. Fiber-reinforced composite resins (FRCRs) are new to the pediatric dental market, and they can be used as fixed alternative for provisional replacement.
FRCRs materials such as a pre-impregnated unidirectional glass fiber system  or a multidirectional, leno-weave reinforcement ribbon  used with resin bonding techniques is available for quick and esthetic replacement. This clinical report presents a technique for fabricating a provisional anterior fixed restoration with composite, reinforced with non-impregnated unidirectional glass fibers. This is a non-invasive and reversible procedure during the time period necessary to develop and implement the definitive treatment plan.
| Case Report|| |
A 12-year-old patient with missing maxillary right central incisor was referred for prosthetic treatment to Department of Prosthodontics, Chattrapati Sahuji Maharaj Medical University. Chief complaint was demand for esthetic replacement of missing maxillary anterior tooth. The clinical and radiographic examinations revealed that the patient had missing maxillary right central incisor, stable maximum intercuspation position, canine protected occlusion and adequate periodontal health and root support without any residual ridge deficiency but mandibular right central incisor impinging incisive papilla [Figure 1]. Conventional fixed partial denture and implant supported restoration could not be planned due to large pulp chamber of abutment teeth and unwillingness of patient for surgical procedure respectively, so provisional restoration was planned. Interim removable partial denture and glass fiber reinforced composite resin fixed partial denture (FRCFPD) were presented to patient as treatment options. The merits and demerits of these options (prosthesis) were also discussed. The patient desired for a FRCFPD rather than interim-removable partial denture.
Enameloplasty of mandibular right central incisor was done to protect the incisive papilla from impingement and the palatal groove, at least three quarters of the mesiodistal width of the abutment teeth, was prepared on the palatal surfaces of the right maxillary lateral and left maxillary central incisors using a round diamond rotary cutting instrument (G+K Mahnhardt Dental, Thurmansbang, Germany). The length of fiber ribbon (Interlik,Angelus,Brasil) was determined by placing a piece of dental floss from the distal surface of one abutment tooth to the distal of the other, and a piece of the fiber ribbon was cut to this length. The abutment groove surfaces and the mesio-proximal surface of the right maxillary lateral and disto-proximal surface of the left maxillary central incisor were etched with 37% phosphoric acid (Total Etch, Ivoclar,Vivadent) for 30 s. The preparations were rinsed with water and thoroughly dried.The ribbon was prepared for bonding by first wetting it with a bonding agent (Single Bond, 3MESPE). A small amount of a hybrid, small particle, universal composite resin (Z100, 3M ESPE) was injected into the groove. The ribbon was bonded to the lingual surfaces of the abutment teeth [Figure 2]. A layer of composite resin, approximately 0.5 mm thick, was placed on top of the ribbon to secure it in place. The pontic was built directly in mouth and it was bonded to acid-etched enamel and the freshly polymerized FRC framework and its air-inhibited surface [Figure 3].This resulted in an excellent bond between the FRC and the lingual surfaces of the abutment teeth and the pontic to the proximal surfaces of the abutments [Figure 4]. The occlusion was evaluated with articulating paper (Hanel Articulating Paper; Coltène/Whaledent, Inc), the premature contacts were eliminated, and the provisional FPD was polished with an abrasive impregnated rubber finishing system (Enhance, Dentsply Intl, York, Pa). Patient was instructed to maintain oral hygiene. Over the 12 month period following the FRCFPD, the patient was examined 4 times. Evaluation of the restorations at these visits indicated that there was no plaque accumulation on the fiber-composite resin combination, and no caries was observed on the abutment teeth.
|Figure 3: Right maxillary central incisor pontic bonded to acid-etched enamel and the freshly polymerized FRC framework and its air-inhibited surface|
Click here to view
| Discussion|| |
This clinical report describes the successful esthetic provisional replacement of a central incisor in pre-adolescent patient with conservative FRCFPD over short-term follow-up.
The development of dentin adhesive systems has led to simpler and minimally invasive preparations. , Adhesive resin cements are composite resins that have a decreased proportion of filler, with an organic polymer matrix of bis-GMA and UDMA, an inorganic filler, bonding agent, initiators and pigments.  Newly introduced resin luting agents have higher proportions of filler.  The combination of the resin luting agent and bonding systems is one of the most important factors for retention of these restorations.
FRCFPDs have potential to be used as long-term provisional restoration.  Continuous fiber-reinforced composites (FRCs) have good flexure strength and other desirable physical characteristics as a fixed prosthesis substructure material. ,, In addition, the FRC substructure is translucent and requires no opaque masking, which allows for a relatively thin layer of particulate covering composite and excellent esthetics. The light-polymerized FRC substructure retains a sticky oxygen-inhibited layer on its external surface that allows direct chemical bonding with the covering composite.  Although, unnecessary preparation and etching of the abutment teeth (though minimally done) is an irreversible damage.
The successful FRC restorations have following limitations:
- Functional stresses and occlusal loading of the pontic should be minimum.
- Vertical and horizontal overlap should not be greater than 3 mm. 
- Supporting abutment teeth should be structurally vital and intact. 
| Conclusion|| |
This clinical report describes a conservative, esthetic fiber-reinforced composite FPD using a direct technique that incorporated a bondable ribbon. This provisional restoration not only satisfied patient needs but also survival was long term and acceptance was better.
| References|| |
|1.||Freilich MA, Meiers JC, Duncan JP, Eckrote KA, Goldberg AJ. Clinical evaluation of fiber-reinforced fixed bridges. J Am Dent Assoc 2002;133:1524-34. |
|2.||Chan DC, Giannini M, De Goes MF. Provisional anterior tooth replacement using nonimpregnated fiber and fiber-reinforced composite resin materials: A clinical report. J Prosthet Dent 2006;95:344-8. |
|3.||Iglesia-Puig MA, Arellano-Cabornero A. Inlay fixed partial denture as a conservative approach for restoring posterior missing teeth: A clinical report. J Prosthet Dent 2003;89:443-5. |
|4.||Edelhoff D, Spiekermann H, Yildirim M. Metal-free inlay-retained fixed partial dentures. Quintessence Int 2001;32:269-81. |
|5.||Ferracane JL. Materials in dentistry: Principles and applications. 2 nd ed. Philadelphia: Lippincott Williams and Wilkins; 2001. p. 74-82. |
|6.||Vallittu PK. Prosthodontic treatment with a glass fiber-reinforced resin-bonded fixedpartial denture: A clinical report. J Prosthet Dent 1999;82:132-5. |
|7.||Karmaker AC, DiBenedetto AT, Goldberg AJ. Fiber reinforced composite materials for dental appliances. Indianapolis: Society of Plastic Engineers ANTEC, May 5-9, 1996. |
|8.||Freilich MA, Karmaker AC, Burstone CJ, Goldberg AJ. Flexure strength of fiber-reinforced composites designed for prosthodontic application. J Dent Res 1997;76:138. |
|9.||Freilich MA, Karmaker AC, Burstone CJ, Goldberg AJ. Flexure strength and handling characteristics of fiber-reinforced composites used in prosthodontics. J Dent Res 1997;76:18. |
|10.||Freilich MA, Karmaker AC, Burstone CJ, Goldberg AJ. Development and clinical applications of a light-polymerized fiber-reinforced composite. J Prosthet Dent 1998;80:311-8. |
|11.||Ricketts RM. Provocations and perceptions in craniofacial orthopedics: Dental science and facial art/parts 1 and 2. Vol 1. Denver: Rocky Mountain Orthodontics; 1990. p. 702-3. |
|12.||Rose E, Frucht S, Jonas IE. Clinical comparison of a multistranded wire and a direct bonded polyethylene ribbon-reinforced resin composite used for lingual retention. Quintessence Int 2002;33:579-83. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]