Читать книгу Fundamentals of Fixed Prosthodontics - James C. Kessler - Страница 108

The resin-bonded fixed partial denture is a conservative restoration that is reserved for use on defect-free abutments in situations where there is a single missing tooth, usually an incisor or premolar. A single molar can be replaced by this type of prosthesis if the patient’s muscles of mastication are not too well developed, thus assuring that a minimum load will be placed on the retainers. The resin-bonded fixed partial denture requires an abutment both mesial and distal to the edentulous space.

This prosthesis utilizes a standard pontic form, accommodating an edentulous ridge with moderate resorption and no gross soft tissue defects. Because it requires a shallow preparation that is restricted to enamel, the resin-bonded fixed partial denture is especially useful in younger patients whose immature teeth with large pulps are poor candidates for endodonticfree abutment preparations.

Tilted abutments can be accommodated only if there is enough tooth structure to allow a change in the normal alignment of axial reduction. This is limited by the need to restrict most of the reduction to enamel. Rarely can a mesiodistal difference in abutment inclination greater than 15 degrees be accommodated. There can be little or no difference in the inclination of the abutments faciolingually.

The resin-bonded prosthesis cannot be used for replacing missing anterior teeth where there is a deep vertical overlap. Reduction deep into the underlying dentin of the abutment teeth will be required in this situation, so a conventional fixed partial denture should be employed.

Although this type of prosthesis has been described for periodontal splints, it should be used with extreme care in those situations. Preparations will demand additional resistance features, such as long, well-defined grooves. Abutment mobility has been shown to be a serious hazard in the successful use of this type of restoration.