Dummer P M, Gidden J R
Department of Conservative Dentistry, University of Wales.
Restorative Dent. 1990 Aug;6(3):9-14.
Resin bonded cast metal bridges have become a popular method of replacing missing teeth. Such bridges are usually constructed as single castings following modifications to the abutment teeth in order to ensure a distinct path of insertion and to secure maximum metal to tooth contact. Unfortunately, long term retention of resin bonded bridges cannot be guaranteed and many surveys have reported substantial failure rates, particularly in the posterior segments of the mouth. It is the authors contention that many of these failures occur because clinicians are neglecting one of the fundamental principles of fixed bridge prosthodontics, namely that abutment teeth should be matched for effective root surface area (bony support). This article describes how problems created by incompatible abutment teeth can be overcome successfully by the construction of resin bonded bridges in two parts which are cemented separately, but interlock to provide a movable joint. Such an arrangement allows independent movement of the abutment teeth whilst providing sufficient retention and support for the bridge. The two-part design can also overcome problems created by malaligned abutment teeth as well as allowing conventional full crown retainers to be combined with resin bonded retainers.
树脂粘结铸造金属桥已成为一种常用的缺牙修复方法。这种桥通常是在对基牙进行修整后作为单个铸件制作而成，以确保有明确的就位道，并确保金属与牙齿的最大接触面积。不幸的是，树脂粘结桥的长期固位无法得到保证，许多调查都报告了相当高的失败率，尤其是在口腔后部。作者认为，这些失败中有许多是因为临床医生忽视了固定桥修复学的一项基本原则，即基牙的有效根表面积（骨支持）应相互匹配。本文介绍了如何通过分两部分制作树脂粘结桥来成功克服由不相容基牙产生的问题，这两部分分别粘结，但相互锁定以提供一个可动连接。这样的设计允许基牙独立移动，同时为桥提供足够的固位和支持。这种两部分设计还可以克服由排列不齐的基牙产生的问题，并且允许传统的全冠固位体与树脂粘结固位体相结合。
