IADR Abstract Archives
Treatment of Agenesis of Lateral Incisors With Resin-Bonded Ceramic Cantilever Bridges. a Case Report.
Objectives: Clinical trials show that replacing missing lateral incisors with a resin-bonded cantilever ceramic bridge perform well in the long-term. The objective of this case report is to present the replacement of two missing lateral incisors in an adult patient following a combination of orthodontics and placement of resin-bonded ceramic cantilever bridges.
Methods: A 31-year old male patient consulted the Department of Restorative Dentistry with agenesis of both maxillary lateral incisors. He complained about the unesthetic appearance as very large diastemata were present between the upper anterior teeth. The treatment plan included: 1. orthodontic closure of the central diastema in order to create sufficient space for replacement of the lateral incisors, 2. replacement of the lateral incisors with 2 resin-bonded zirconia cantilever bridges. This type of restoration was selected because of the minimally invasive character and the relatively low cost compared to tooth replacement with an implant. After orthodontic treatment, an essix retainer was made with replacement of the lateral incisors in composite, on wich an ovate pontic was formed. After formation of the ponticbed, an intra-enamel preparation was made on the central incisors and an impression was taken. Two weeks later, the monolithic zirconia cantilever bridges were bonded. The inner surface of the zirconia wings was pretreated with airabrasion (30 mm A2O3, 1 bar), followed by cementation of the bridges with Panavia V5 (Kuraray Noritake) under rubberdam isolation. Attention was paid that the lateral incisors were discluded during anterior guidance.
Results: The patient was very satisfied with the final esthetic result. Yearly follow-up of the restorations was planned.
Conclusions: Replacing missing lateral incisors with resin-bonded cantilever zirconia bridges is a minimally invasive treatment, easy for the dentist to perform. Attention must be paid to the space available, the quality of the abutment teeth and the occlusion. An accurate bonding protocol must be followed to obtain long-lasting restorations.
Methods: A 31-year old male patient consulted the Department of Restorative Dentistry with agenesis of both maxillary lateral incisors. He complained about the unesthetic appearance as very large diastemata were present between the upper anterior teeth. The treatment plan included: 1. orthodontic closure of the central diastema in order to create sufficient space for replacement of the lateral incisors, 2. replacement of the lateral incisors with 2 resin-bonded zirconia cantilever bridges. This type of restoration was selected because of the minimally invasive character and the relatively low cost compared to tooth replacement with an implant. After orthodontic treatment, an essix retainer was made with replacement of the lateral incisors in composite, on wich an ovate pontic was formed. After formation of the ponticbed, an intra-enamel preparation was made on the central incisors and an impression was taken. Two weeks later, the monolithic zirconia cantilever bridges were bonded. The inner surface of the zirconia wings was pretreated with airabrasion (30 mm A2O3, 1 bar), followed by cementation of the bridges with Panavia V5 (Kuraray Noritake) under rubberdam isolation. Attention was paid that the lateral incisors were discluded during anterior guidance.
Results: The patient was very satisfied with the final esthetic result. Yearly follow-up of the restorations was planned.
Conclusions: Replacing missing lateral incisors with resin-bonded cantilever zirconia bridges is a minimally invasive treatment, easy for the dentist to perform. Attention must be paid to the space available, the quality of the abutment teeth and the occlusion. An accurate bonding protocol must be followed to obtain long-lasting restorations.