Maret 02, 2017
this video shows the technique for makinga single-appointment bridge using ribbond reinforcement fiber, which is perhaps themost common ribbond application worldwide. these bridges are quick and easy to make andvery well received by patients. please note that this video is intended to provide anoverview of the procedure and that it is not intended to be used in lieu of the instructionsthat are included in the ribbond kit. a ribbond bridge can be made either intraor extra-coronally depending on the and the particulars of the specific case. this video shows a case without preparationsto the abutments.â whether preparations are used or not, the technique for making theribbond bridge is more or less the same. if
the abutment teeth are periodontally mobile,the ribbond wings can be extended to multiple abutments. first, you will need to decide what to useas a pontic. if you just extracted a natural tooth you can use it as the pontic. you canalso make a pontic using an acrylic denture tooth or a free hand composite build-up. youwill want to choose and shape the pontic prior to making the ribbond framework. measure the area where the ribbond will beplaced using the dead soft tinfoil providedâ in the ribbond kit, waxed dental floss can alsobe used as well. then cut the ribbond to the corresponding length.
a small amount of tacky viscosity compositecan be used to help hold the template in position two layers of ribbond will be used for makingthe bridge framework. the first layer will extend from abutment-to-abutment. the secondlayer will double up against the first layer only in the pontic area.â adapt the tinfoilor dental floss to the teeth as you would adapt the ribbond. cut or mark the end ofthe template to indicate the length that will needed to cut the ribbond. please note: youâ maywant toâ err on the side of cutting too much rather than cutting too little as you cantrim the excess ribbondâ before polymerizing with the special ribbond scissors. cut open the plastic packaging and use cottonpliers to extract the ribbond. cut the two
ribbond pieces with the special ribbond scissors.ribbond is made from the same ultra-high molecular weight polyethylene fibers used to make bulletproofvests and normal scissors will not cut it cleanly. reseal the ribbond by folding over the endof the packaging and securing it with the paper clip. this will help to maintain ribbond'sindefinite shelf life. clean the teeth and prepare the teeth forbonding. clean, acid etch the teeth, and apply the bonding adhesive using your standard bondingtechnique and materials. please note that since there is no clinicalevidence supporting the use of self-etching resins for this type of retentive bonding,we do not recommend using self-etching resins
for this procedure. apply a thin layer of ribbond securing compositeor soft filled composite to the teeth. we don't recommend using a flowable compositefor this step because flowables tend to lack the tackiness to hold the ribbond in positionprior to curing. ribbond, inc. has a specially formulated filledcomposite resin designed for bonding the fibers to the teeth. it has a viscosity that is betweena flowable composite and a filled restorative composite. this video shows the techniqueusing the ribbond securing composite. if you do not have the ribbond securing composite,we have a list of some of the composite resins that we recommend for this step of the procedurefrom major manufacturers on our website.
if using a paste viscosity composite, placea thin bead of composite on the teeth, and then with an instrument, flatten it to mimicthe contours of the teeth. flattening the composite will make adaptation easier andreduce the amount of composite that needs to be displaced when placing the ribbond.try to make this layer approximately half a millimeter thick. wet the first piece of ribbond with a 4thgeneration unfilled adhesive bonding resin. after the ribbond is wetted with the bondingresin, you can now touch it with your fingers or powder-free latex gloves. do not wet the ribbond with a bonding resinthat contains a dentin primer or self-etching
component. if you do not have a suitable resinalready in your office, ribbond, inc. offers the ribbond wetting resin, which is specificallydesigned for wetting ribbond fibers. hold the wetted ribbond with cotton pliersand starting on one end, press the ribbond into the composite resin that was previouslyapplied to the teeth. use your fingers or instruments to press the ribbond through thecomposite closely against the tooth surfaces. remember, the thinner the bond line is thebetter the results so try to displace as much composite as possible. this will not onlyminimize bulk and aid in patient comfort but it will also maximize the laminate effectand increase longevity. use cotton pliers and bring the ribbond acrossthe edentulous area and gently adapt the ribbond
into the composite on the other abutment.again, place the ribbond as close to the surfaces of the teeth as possible. if the ribbond pieceis too long, cut the excess with the special ribbond scissors prior to curing. try to make the ribbond cross the pontic spacein a straight line, and orient the ribbond so that it is placed under the incisal edgeof the pontic. this way the forces from the pontic will be directed onto the ribbond framework. after placement, using the same thin tippedinstrument, carefully remove the excess composite resin that was displace during the adaptationof the ribbond. move the instrument parallel to the lengthwise orientation of the ribbondto avoid accidentally displacing the ribbond.
after the first piece of ribbond is adapted,polymerize the framework according to the composite manufacturer's instructions. wet the second piece of ribbond using theribbond wetting resin or a bonding adhesive that does not contain a dentin primer or acidetchant. place a thin layer of the same filled compositethat we used earlier in the procedure on the lingual side of the ribbond in the edentulousarea. extend this composite layer onto the interproximal angles of both abutments. gently place the ribbond against the layerof composite. try to maintain a 0.5 mm thickness of composite resin between the two layersof ribbond.
polymerize the second piece of ribbond. if using an acrylic denture tooth or a naturalcrown as a pontic, cut a lingual channel to accommodate the ribbond framework. if usingan acrylic denture tooth, you will be relying on mechanical retention so make undercutswithin the groove preparation to the acrylic denture tooth. small holes can be placed inthe groove for added mechanical retention using a small burr. fill the groove with composite,seat on framework, check placement, and polymerize. cover the ribbond within the channel of thepontic with composite to build up the lingual side of the pontic. pontic or the pontic can also be constructedfreehand in place with composite.
cover the lingual surfaces of the ribbondbridge wings to make the prosthesis smooth and comfortable for the patient. for extracoronal applications we recommend a flowable composite for covering the lingual wings onthe abutments. this can be applied in multiple layers using a microbrush or other small brushto make the wings smooth and comfortable for the patient. do not use the ribbond securing compositefor the covering layer as it is too tacky. ribbond fibers do not polish well but theyneed to be covered with resin. you want to avoid having to shape and polish the prosthesisusing rotary instruments. when the covering layer is finished, thoroughlycure.
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