This adhesive varnish is utilized to affix micro- and macroretention beads to the surface of restorations after modelling. Two different sizes of retentins beads are available, depending on the space available. Microretentions with — micron and Macroretentions with — micron. SR Link is a metal-composite bonding agent that provides a covalent bond between the metal framework and SR Adoro. SR Link is an easy-to-use and, above all, tried-and-tested bonding system that can be used in conjunction with a wide selection of alloys.
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Rangoonwala Dental College, Pune, India. This report describes a step-by-step sequence for preparation for a posterior partial veneered restoration for a space closure using a Maryland bridge—design veneered with a heat-cured composite resin.
The modality provides sound posterior occlusal function, combined with a psychological satisfaction to the patient of regaining a missing tooth.
The preparation takes into account the design for resin-bonded prostheses. This article presents the preparation and build-up method for a metal reinforced posterior partial veneered restoration through a conservative palatal approach for a highly aesthetic result. The resin-bonded Maryland Bridge has been considered as a popular substitute for conventional full-coverage bridges to avoid crowns on the non-restored abutments. This design has been particularly useful as a conservative option to a single-tooth replacement.
Lividitis and Thompson first developed this technique by electrolytically etching the intaglio surface inner side of a non-precious-alloy bridge framework to produce a microscopically roughened surface for providing suitable mechanical retention to the tooth structure through an adhesive luting cement. However, improvements in bonding systems have led to a truly adhesive restoration as opposed to one relying on the micro-etched surface for retention. Adhesive cementation of the alloy to the tooth structure allows the casting to be supported by abutment teeth.
The design for the Maryland bridge generally allows for a single path of insertion thus avoiding displacement along any other path except the path of insertion of the prosthesis. Adhesive bonding further strengthens the bond between the framework and the tooth structure, thus increasing the overall success rate of the restoration. This clinical report describes a conservative method for replacement of a missing posterior tooth using a Maryland bridge with a build-up of heat-cured composite resin SR Adoro System.
A year-old male complained primarily of poor aesthetics because of a missing left maxillary premolar. The span of the missing tooth was too small in proportion to the space for the premolar. Both the left maxillary canine and the second premolar were intact. The patient was given a wide array of treatment options; including de-rotation of the premolar and a fixed partial denture to a single tooth implant. Since the patient did not agree to spend the time and money required for the treatment, therefore, a resin-bonded fixed partial denture was suggested and he agreed.
Pre-Operative condition: note rotated maxillary left second premolar and missing first premolar. Accordingly a pre-operative impression was taken in irreversible hydrocolloid Zelgan, Dentsply, Switzerland and duplicated. The clinical preparation was done accordingly by first disking 0. A preparation similar to that of a three quarter was done on the premolar and chamfer margin was placed, whereas only the lingual surface reduction was done for the canine[ 3 , 4 ] [ Figure 2c ].
The wax pattern was fabricated on the master cast and retention beads were placed using a retention adhesive. These were later reproduced in the metal framework [ Figure 4 ]. The missing tooth was fabricated using the light-activated heat-cured composite resin material SR Adoro, Ivoclar Vivadent, Germany. The areas of the retention beads were blocked using the Adoro Opaquer material to prevent reflection of the metallic surface [ Figure 5 ].
The opaquer was cured in the curing unit Lumamat , Ivoclar Vivadent, Germany for 11 min. The inhibition layer was removed using a sponge provided with the system [ Figure 6 ]. A ridge-lap-type pontic of the premolar was designed using incremental addition of composite and layering of stains, while each increment was cured for 20 s under the Quik SET Ivoclar Vivadent, Germany [ Figure 7 ].
The prosthesis was subjected to the final curing cycle for 25 min [ Figure 8 ]. Finished prosthesis was finished using fine and super fine diamond abrasives Mani Diaburs, Japan Final polishing was done using polishing discs SuperSnap, Shofu, Japan. Notice the stains and characteristics imparted on the proximo-buccal portions. The patient followed a regular check-up program after seating of the prosthesis.
This treatment modality presents as a quick and efficient method to provide satisfactory aesthetics with minimal tooth loss. There is less chairside time required and usually no anesthesia is needed. If anesthesia is needed, it is usually for the developing of a soft tissue pontic receiving site on the edentulous ridge or removal of deep carious lesions on the abutment teeth if any.
An aesthetic advantage is that only the lingual surfaces of anterior teeth are covered, and therefore no metal from the retainers show. The ease of use and wide range of shades allow the dentist to fabricate the prosthesis to even the most minute of details to provide a true to natural effect.
The composite material can be finished and polished like regular direct composite restoratives. The only disadvantage to a Maryland Bridge is that it is extremely technique sensitive.
Each and every step requires a proper planning and precision including recording impressions, surface treatment of the metal framework, and bonding. The Maryland Bridge has undergone many alterations since its introduction in , although the basic advantage of conservation of tooth structure has remained.
Retention has been improved with a more retentive framework design, the addition of grooves, labial wrap, and the concept of maximum coverage of the enamel. Improvements in material will continue. If the dentist maintains meticulous attention to detail and proper patient selection, the Maryland Bridge will continue to be not only a conservative restoration alternative, but a primary choice.
In addition, with all the innovative technology available, variations of the original design are limited only by the imagination of the dentist and the dental laboratory. Read article at publisher's site DOI : To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation. Monaco C. J Adhes Dent , 14 5 , 01 Aug Cited by 1 article PMID: Shimizu H , Takahashi Y. Cited by 2 articles PMID: Moslehifard E , Farid F.
Hegde VS. Affiliations 1 author 1. Share this article Share with email Share with twitter Share with linkedin Share with facebook. Free full text. J Conserv Dent. PMID: Author information Article notes Copyright and License information Disclaimer.
Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Go to:. Keywords: Heat-cured composite, partial veneered restoration, resin-bonded prosthesis, SR Adoro system. Open in a separate window. Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure Livaditis GJ.
Cast metal bonded retainers for posterior teeth. J Am Dent Assoc. Livaditis J, Thompson VP. Etched castings: An improved retentive mechanism for resin-bonded retainers. J Prosthet Dent. Anterior retainer design for resin-bonded acid-etched fixed partial dentures. Relationship between sand blasting and composite resin-alloy bond strength by silica coating.
ADORO, Ivoclar Vivadent – Germany ( In-directly Bonded to teeth )
Fixed Prosthetics - metal-supported. SR Adoro is suitable for the fabrication of both metal-supported and metal-free restorations. SR Adoro is characterized by those handling properties typically found in light-curing composites. The material is fast and convenient to use. Given its soft consistency and excellent modelling properties, SR Adoro enables swift and smooth application procedures.