Clinical case-stidies: Fibrebond U Shape fibre Upper central. Dr J Van Rensburg
U-shape fibre used to reinforce the pontic. This technique was developed by Dr Van Rensburg to obtain a more predictable outcome of the FRC bridge.
Patient
Male, 65
Case history
The patient lost his upper left central and was made a removable denture by his dentist to replace the missing tooth. Unfortunately he could not get used to the removable denture as he found it extremely uncomfortable. A consultation appointment was arranged for the patient. During the consultation appointment all the relevant treatment options to replace this tooth were discussed with the patient in detail. After the patient decided on the Fibre reinforced composite bridge solution the procedure was explained to the patient. The clinical case (Bridge for anterior region) on the DVD from StickTech Ltd. was shown to the patient for proper illustration of the whole procedure. The patient was given a patient information leaflet and was also asked to visit www.fibrebond.co.uk for more information about the fibres. All the costs involved were discussed and the patient was asked to sign a copy of the printed, estimated treatment plan. The patient was also given a copy of the estimate.
Treatment
A silicone model was created. Futar Model and Futar Retar D was the material used for the model construction. The fitting surface was built up with composite after which a U-shape fibre (everStick Perio) was formed and cured on the model. This partially formed pontic could now easily be positioned in the mouth. The U-shaped fibre would guide the pontic into position in the mouth. (Fig 1.) The fitting surface of the pontic is polished prior to bonding it into the mouth. (Fig 2) Prior to rubber dam isolation the partially made pontic is tried in, in the mouth (Fig 3). Rubber dam isolation is strongly recommended (Fig 4). No cavity preparation was done on the teeth. Only the enamel was roughened with a fine diamond bur. The enamel was etched where the fibres are to be bonded (Fig 5). An everStick C&B fibre was bonded on the palatal side of the UR1 and UL2. The length of all fibres was measured with ligature wire(Fig 6). The dentine part of the pontic was built up with a dentine shade of composite (Fig 7). The enamel layer with some incisal transparent composite was added to obtain the end result (Fig 8). The added pontic fitted well onto the gingiva as can be seen on the palatal view. Note the incisal transparency which gives an excellent finish (Fig 9).
Fig 1 U-shape fibre
Fig 2 Polish partially constructed pontic
Try-in
Rubber dam
Etch and Bond
Palatal C&B fibre and the U-shape Perio fibre
Dentine Build-up
Final result
Palatal view final result
