Fibre Bond Ltd - Empowering Dentists

About the Fibre Reinforced Composite Bridge (FRC)

Click on a question to display the answer.

• What is a Fibre reinforced composite (FRC) bridge?

  The FRC bridge is a minimally invasive and cost-effective way to replace a missing tooth or teeth. Instead of metal, glass fibre strands (or bundles) are used to create a fibre frame (see below). The missing tooth or teeth are tooth-shaped white filling (composite) material. The glass fibre bundles are embedded in the white filling material. The fibre frame is attached to the natural teeth with an adhesive. The bond between composite resin and tooth enamel is the strongest bond possible in the mouth. The strength of the everStick fibres is as high as that of chrome cobalt cast metal and has the advantage of not being completely rigid, but has similar elasticity to that of dentine. The anchor teeth are undamaged unlike normal bridgework where almost all the enamel of the anchor teeth is removed during the bridge preparation.

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• What are other treatment options available to replace missing teeth?

  1. Dental Implants

  Implants are considered to be the best treatment to replace a missing tooth or teeth. During implant treatment a metal (normally titanium) screw is inserted into the jawbone. The screw is left in the bone for some time so that it can integrate with the bone although in some cases it is possible to place the implant immediately after an extraction. This then provides an anchor for the crown. In most cases the crown is made of metal covered with porcelain.

  Advantages and disadvantages of Implant treatment option:

  • Very reliable with good long-term results
  • No damage to the teeth on either side of the “gap” and the replaced tooth is not connected to the adjacent teeth.
  • The procedure can be done under local anesthesia (normal dental injection)

  Disadvantages of implant treatment:

  • The treatment is expensive.
  • It can take as long as 9 months before the treatment can be completed and the crown is permanent. (In some cases immediate placement after an extraction is considered.)
  • In certain cases the amount of bone may not be sufficient and bone grafts are required. This will lead to an increase in cost and the treatment time.
  • As with any other dental treatment, failure of the implant is always a possibility.

  2. Conventional 3 unit bridge

  This option is not recommended now as a large amount of natural enamel and dentine are removed during the bridge preparation. This option used to be popular but due to its invasive nature, other procedures are preferred.

  3. Mary-land bridge

  The results of this technique are good and less invasive but the reliability is sometimes questioned.

  4. Denture

  Replacing missing teeth with a denture is unreliable and is not generally the treatment of choice as the result is less attractive and less successful.

• Why will I need a FRC Bridge?

  1. Temporary replacement of a tooth or teeth before implant procedure

  • During the healing process after an extraction
  • As an immediate replacement - whilst waiting for the implant.
  • Financial reasons - patient can’t afford an implant now and would like to have the implant at a later stage.

  2. Immediate semi-permanent replacement

  After extractions due to:
  

  • Fractured Root (Metal post retained crown)
  • Periodontal disease (periodontal Abscess).
  • Unrestorable teeth

  3. Permanent Replacement

  Where:
  

  • Conventional bridge preparation too invasive.
  • An implant is not suitable.
  • Dentures are not desirable.
  • Prognosis of the adjacent (or anchor ) teeth are doubtful and a more cost-effective solution is required. Eg. The periodontally compromised patient.

• What does the literature say about FRC Bridges?

  ALTHOUGH WE SAY “NEW”, FIBRE TECHNOLOGY IS:
  

  • Scientifically proven (more than 300 scientific publications)
  • A tried and tested method
  • Used worldwide in Europe, the UK, the USA and South Africa
  • Well researched and well documented (see the list of publications)

  Here are some reports to prove the durability of the FRC bridges:

  1. Vallittu PK. J Prosthet Dent 2004;91(3):241-246.

  This is a press release by Prof Pekka Vallittu comparing the FRC bridges with metal alloy resin bonded bridges (Mary Land Bridges) over a period of 63 months. He reported a 93 % functional survival rate over the period of 5 years. The fact that these bridges can be repaired (if necessary) in the mouth is a great advantage to the FRC bridges. Conventional bridges and Maryland bridges are almost unrepairable in the mouth and need to be redone if anything goes wrong.

  

  2. Dr Kari Pihlman (Läkkitori Dental Clinic, Espoo, Finland).

  He reported:
  

  • 35 chairside manufactured bridges
  • 100% success after 4,3 years.

  3. Dr J.J.Jansen van Rensburg (Oak Lodge dental clinic, Heathfield, East Sussex, UK.)

  Dr. J.J. Jansen Van Rensburg has been involved with direct FRC restorations since 2003 with bridges surviving 6 years. He recently completed a clinical audit regarding the fibre cases done by himself at Oak Lodge Dental Clinic. He reported 93 fibre cases of which 45 were FRC bridges, with a survival rate of 100% after 2 years.

  4. The Doctoral Thesis of Prof Scott R Dyer:

  “FIBRE-REINFORCED COMPOSITE BRIDGES STRONGER THAN CONVENTIONAL PORCELAIN FUSED TO METAL BRIDGES
  For some clinical situations, we can make crowns and bridges with the everStick system without significant tooth reduction. This represents a potentially significant advancement in prosthetic dentistry.”

• What does the procedure involve?

  Most cases of FibreBond bridges are completed without local anaesthesia. Very little preparation (only roughening of the enamel) is done to the anchor teeth. In some cases a very shallow groove preparation may be considered. This groove stays within the enamel where the best bonding will be obtained. Placing rubber dam isolation in these cases will simplify the procedure for both the dentist and the patient and is recommended. Rubber dam isolation is a rubber sheaf that fits around the teeth (see below). This will isolate the working area and will form a shield to protect the patient’s airway. Please inform your dentist if you are allergic to latex!

• What are the main advantages of the FRC bridges against other replacement treatment options?

  • Cost effective treatment option. Half the cost of conventional bridge work.
  • Less drilling - most cases done without dental injections
  • Very little preparation on the anchor teeth.
  • Single appointment procedure.
  • If required, the structure can be easily repaired or remodelled
  • Immediate - no waiting for the final prosthesis
  • Reversible. - as no damage is done to the anchor teeth, the fibre can be removed and other treatment options can follow.

  

• What are the disadvantages of the FRC bridges

  • Longer appointments necessary - as the teeth are built up directly in the mouth. To compensate for this, frequent breaks should be provided by the operating dentist.
  • Staining of the composite materials is the main disadvantage. Regular polishing by the dentist or oral hygienist is recommended. In severe cases the composite replacement tooth may need a fresh layer of white filling material to get rid of the staining. Smoking Rubber dam isolation in the mouth ,tea, coffee, red wine and certain foods can cause staining of the white filling material. The normal 6 monthly check-up routine will ensure proper maintenance of the FRC bridge by your dentist or oral hygienist.
  • Daily maintenance of the bridges is very important. You should be able to remove all accumulating plaque from the bridge, especially in the area of the replacement tooth or teeth. Inter-dental cleaning brushes such as the different coloured “TePe brushes” or special floss called “Super Floss” should be used every time you clean your teeth. Your dentists and oral hygienist should demontrate to you how to maintain you FRC bridge.

• How long do the FRC bridges last?

  • The FRC bridges can last for many years as proved by the previous reports.
  • Regular maintenance and frequent reviews are important.
  • If any sharp edges or cracks are felt or detected it must be reported to the dentist. As mentioned these bridges can easily be repaired in the dental chair with a simple composite filling procedure.

• What will a procedure like this cost me?

  • The fact that these fibres are new technology and the treatment requires special skills , means the fee charged might differ from practice to practice.
  • The fee for a FRC bridge can be from £400 (as at April 2009) and these are some of the factors that will be taken into consideration when quoting a fee for your FRC bridge:
    • The number of replacement teeth.
    • The preparation on the anchor teeth.
    • The construction of the fibre frame.
    • The amount of fibres used in the FRC bridge.
    • The quality of the composite material.
    • The method used to construct the FRC bridge - there are different ways for different cases.
    • The position of the bridge in the mouth.
  • The FRC bridges are cost-effective and are, in most cases, half the fee of a conventional porcelain fused to metal bridge. It is also approximately less than one third of the fee for an implant retained crown.

Patients please be aware of the following...

During the first 48 hours after the Fibre reinforced composite treatment, you will experience:

• A feeling of tightness because the teeth are bonded together.
• The saliva glands might produce more saliva because of the new foreign object on the teeth.
• The speech might be very slightly affected (only in rare cases where the front teeth were treated).
• Any rough or sharp edges or points must be reported to the dentist during the follow up appointment or before that.