Emergency direct fabrication of a resin fixed partial denture by using a ceramometal crown with reinforcing woven polyethylene ribbon as a pontic

Abstract

In this emergency case of a fractured tooth, immediate short-term treatment was necessary to relieve pain and replace a missing coronal portion of the maxillary central incisor. The need to remove additional fractured root fragments subgingivally precluded accessibility to the remaining root for conventional restorative procedures. The patient could not decide which course of treatment to accept, so a fixed partial denture was fabricated, with the ceramometal crown restoration as a provisional pontic splinted to the adjacent teeth. Restoring and reinforcing the posterior composite splint with a gas plasma-treated woven polyethylene ribbon has been detailed and illustrated. This ribbon material reputed to be 10 times stronger than steel by volume, is a true reinforcing material because it is woven. Mechanically, it becomes an integral part of the splint. Because it is gas plasma-treated, the superficial layer, when placed in BIS-GMA or polymethyl methacrylate, reacts chemically with the resin. The pliable, memory-free fiber--together with the open, woven, lacelike, lock stitch leno--allows the ribbon to follow the contours of the teeth and dental arch easily. The ribbon design reduces and dissipates forces exerted onto the splinting resin. The neutral color of the material permits it to have a chameleonlike effect on the color of the resin into which it is positioned. This ribbon product has been used in other dental applications: periodontal splinting, orthodontic retention, indirect composite fixed partial dentures, long-term temporary restorations with applicability in implant treatments, repair and conversion of prostheses, and reinforcing endodontically treated teeth, and complete dentures and orthodontic retainers when weaknesses are anticipated, such as shallow palatal vaults of complete dentures against a full complement of mandibular natural teeth, and the horseshoe mandibular removable modified Hawley retainer.