CLINICAL ARTICLE

“CLINICAL SUCCESS IN RESIN BONDED BRIDGES”

Fahim Vohra1 M Pros RCS, M ClinDent, MFDS, BDS.

Haroon Rashid2 MDSc, BDS

Resin bonded bridges offer a conservative approach to the restoration of edentulous spaces than conventional
bridgework. However, since their introduction, the main concern regarding resin bonding bridge work has been
increased debonding rates and inferior longevity. Increasing published scientific reports have shown success rates
of seven to nine years provided that vital success factors are respected. Clinical success in resin bonded bridgework
is dependent on identification of high risk cases, appropriate assessment, optimum bridge design, maximum tooth
coverage and meticulous clinical technique. This paper will examine design principles vital in the success of resin
bonded bridgework and present two clinical cases.
KEYWORDS: resin bonded bridge, clinical success, de-bonding, bridge design, case selection
How to cite this article: Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges. J Pak Dent Assoc
2013;22(2):147-153.

INTRODUCTION & stability along with plaque retention remain with them
and they may not be the treatment of choice for most

T ooth replacement is a common dental need warranting

special considerations. Teeth may be missing due
to a number of factors which include trauma, congenital
individuals. Whilst removable prosthesis becomes loose
and unstable with time, dental implants can provide support
for both removable and fixed prosthesis which are both
conditions, caries, periodontal disease, restoration aesthetic and durable. However; implants require clinical
requirements and failed dental treatments. The common expertise, circumferential bone, long-term maintenance,
options available for management of missing teeth include increased expense and cannot be placed in growing
conventional fixed partial dentures, dental implants, individuals and patients with medical contraindications.
removable dentures, no replacement and resin bonded Dentists may hesitate to provide resin bonded metal
fixed partial dentures. restorations because of the fear that the restorations might
Conventional fixed partial dentures are irreversible fail. However, dental literature has a number of studies
options of tooth replacement and require tooth preparation. outlining the improved clinical performance of resin bonded
Preparation sequence when followed requires extensive bridges. These restorations have shown survival rates that
reduction of the abutments which compromises the vitality are acceptable in view of minimally invasive techniques3,4.
of the pulp tissue1. Plaque accumulation, inflammation Creugers et. al., 19915 reported 75% survival rates for the
and gingivitis are also reported to occur in teeth restored anterior RBBs over a period of 7.5 years. Long term median
with conventional crowns & bridges2. Removable partial survival rates of 7 years and 10 months were reported by
dentures (RPD) restore function and aesthetics to an extent Djemal et.al 6 and similar success rates were also reported
and are cost effective, however problems of poor retention by Hussey & linden7. Boyer et. al.8 also demonstrated that
resin bonded bridges can provide predictable long term
1. HOD & Assistant Professor, Department of clinical service . RBBs are considered useful alternatives
Prosthodontics, Ziauddin College Of Dentistry. Ziauddin to conventional crowns and bridges but debonding has
University been considered as main disadvantage of these restorations9.
2. Assistant Professor, Department of Prosthodontics, However if sufficient coverage over the abutment teeth is
Ziauddin College Of Dentistry, Ziauddin University provided, proper case selection is done and the occlusal
considerations are understood during their fabrication,
Correspondence: Dr Fahim Vohra these restorations offer good clinical performance whilst
<fahimvohra@yahoo.com> Cell: 0305-9224353 being conservative.

147 JPDA Vol. 22 No. 02 Apr-June 2013

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

There is no standard registered body to give a number of space of the abutment tooth together with the attached
RBB’s fabricated or fitted in Pakistan. After an online bridge is responsible for the improved performance of
search of journal database in Pakistan cantilever resin bonded bridges compared to fixed-fixed
(www.pakmedinet.com), we were unable to find published RBB. In a fixed-fixed resin bonded design the opportunity
statistical facts related to the percentage of usage of RBB’s for such free movement is lost as the abutment teeth are
in teaching institutes or private practices in Pakistan. This splinted together by the rigid framework. As a result of
makes it impossible to factually comment on the clinical this differential abutment movement, if one retainer
use of these restorations and in some way reflects the debonds, the bridge will still remain in situ and the carious
inferior understanding and under usage of these indirect destruction of tooth tissue may go undetected for some
restorations. This paper will present the factors vital in time. However, using a single retainer eliminates the
clinical success of RBBs and two cases to demonstrate problem of partial decementation as the bond failure is
their clinical application and treatment sequence. instantaneously obvious. This may also be seen as a
disadvantage because of dramatic failure.
FACTORS VITAL FOR CLINICAL SUCCESS OF However, it is suggested5 that it is too simplistic to
RESIN BONDED BRIDGES assume that longevity is automatically associated with
cantilever design. It was proposed6 that the increased
The clinical success in the provision of resin bonded success associated with cantilever bridges is related to
bridges is multifactorial and these are discussed as follows. their selection in relatively ‘safe’ situations i.e. where
a) Case Selection occlusal demands are modest and the stability of the
Patients with para-functional habits can cause excessive abutment is predictable. However the ambitious use of
occlusal loading and increased demands on the cement cantilevers simply to avoid a fixed-fixed alternative is
lute. Similarly, short clinical crowns in patients with tooth cautioned. In situations where the span is of such a length
surface loss, microdontia and hypodontia, teeth which are that an abutment is needed at each end, or where the
heavily restored, and with abnormalities of enamel or with occlusion is more complicated and excursive movements
exposed dentine surface reduce the amount of enamel for on pontics cannot be avoided, or where tooth stability
adhesive bonding. Due to rapid developments in bonding following orthodontic movement is required then a fixed-
to enamel and dentine, techniques and materials, the above fixed design is indicated. A vital factor in decreasing the
mentioned conditions are although not absolute risk failure is also to eliminate sliding contacts across the
contraindications for Resin Bonded Bridges but extra tooth- retainer junction as this could result in tensile forces
precautions should be taken in the designing of connectors between the tooth and retainer, increasing the risk of failure.
and retainers, and bonding techniques. Patients should also A conventional fixed movable-bridge has a rigid
be consented and those with parafunctional habits provided connector usually at the distal end of the pontic, and a
with an hard acrylic splint for night time wear. movable connector on the mesial abutment tooth. It is
b) Bridge and Connector design thought that the fixed-movable design exerts a ‘stress-
There are three possible designs of a bridge based on breaking’ effect, reducing the demands on the minor retainer
retainer type and connectors. and allowing the abutments to retain a degree of independent
axial mobility. In reality whether this happens or not has
• Cantilever RBB yet to be proven and there are no studies that demonstrate
• Fixed-fixed RBB increased longevity when utilising a fixed-moveable design.
• Hybrid bridge With regard to resin bonded bridgework the use of fixed-
movable designs should be limited to hybrid bridges.
Tay and Shaw10 in the year 1982 suggested that where c) Retainer design & coverage
single missing anterior teeth were being replaced with Resin bonding a cast framework was originally described
adhesive (Rochette) bridges then single unit cantilever by Rochette11 and employed as a periodontal splint. This
worked best. However in a study6 of 832 resin retained was based on macro mechanical retention. Howe and
bridges and splints, the median survival for fixed-fixed Denehy12 adapted this concept for a resin bonded bridge
designs was 7.8yrs whereas the median survival for with perforated retaining wings. Such restorations have
cantilever designs was 9.8yrs. become known as Rochette bridges. Livaditis and
The movement allowed within the periodontal ligament Thompson13 superseded this design with an improved

JPDA Vol. 22 No. 02 Apr-June 2013 148

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

retentive mechanism for retainer retention; the etched bonded bridges is conservation of tooth structure, which
casting. This design became known as the Maryland bridge is lost with tooth preparation. It is established that interfacial
after the institute in which the research was carried out. bond strength of resin cements to enamel is far greater
The retainer should cover as much of the crown of the than dentine16, as a result dentine exposure needs to be
abutment teeth as possible without compromising aesthetics avoided during tooth preparation. Use of proximal grooves
or oral hygiene. Maximal coverage increases the surface (1 to 3 mm), is becoming come practice17 for better retention
area for bonding and so increases retention. Increasing the and resistance form of preparations. Other preparation
height of the adhesive wing increases both retention and features include rest seats for a seating stop and resistance
resistance form. Furthermore, wrapping around as much to displacement, parallel proximal surface preparation or
as possible with extension into the pontic area and the guide planes to increase connector height and develop path
tooth’s other proximal surface, therefore enhancing retention of insertion, palatal or lingual reduction for space of metal
and resistance form. retainer and axial reduction supragingival margins allowing
Retainers should be thick enough to ensure that they for 180° wrap around of the retainer to abutment tooth.
are sufficiently rigid to resist flexion. Flexion of retainers However, there is no evidence to suggest that tooth
may cause failure of the cement bond. It has been preparation provides greater success rates6 and to date no
recommended that for nickel chromium a thickness of at comparable data is available. Therefore, a balance needs
least 0.7mm is required14. to be established between decreased risk of de-bonding
d) Framework alloy: and caries development in case of undetected partial failure.
The Ideal Properties for metals alloys in case of resin g) Pontic design
bonded bridges are optimum modulus of elasticity, accuracy Initially, investigators thought that the pontic material
of casting, bonding to ceramic, bonding to resin cements, may have been an important factor in the aetiology of
biocompatibility and acceptable aesthetics. Nickel inflammatory changes beneath bridge pontics. In a further
chromium is preferred over type IV gold as it shows greater investigation18 the plaque retaining capacity of four dental
bond to resin cements15, is less expensive and increased in materials was assessed. They found that the plaque retaining
rigidity. capacity of porcelain and acrylic was significantly different
e) Occlusal management to type III gold and ceramo-metal. Therefore, porcelain
Management of the occlusion is important in the success and acrylic were easier to clean though all could be cleaned
of cantilever bridges. A careful occlusal analysis is required in time. In addition to that, pontic surfaces should be a
to avoid heavy contact on the pontic especially in excursive smooth as possible to prevent them from being plaque
movements which could cause bond failure or tooth rotation. retentive19.
In situations where occlusion is more complicated and The most important features of pontic design are
excursive movements on pontics cannot be avoided then therefore related to its cleansability. Poor cleansibility
a fixed-fixed design is indicated. around pontics can lead to plaque accumulation and hence
Adhesive retainers generally require at least 0.7mm of soft tissue inflammation. Proper oral hygiene instruction
space between abutment teeth and their antagonists, if to the patient and the cleansability of pontics is more
resistance of the framework to flexure is to be adequate. important than the choice of material. Therefore, pontics
Often it is necessary to create space for the framework. should have passive tissue contact with a convex, smooth
There are a number of ways of creating space. fit surface and adequate embrasure space to facilitate
• Preparation of the abutment cleaning.
• Adjustments of the antagonists h) Periodontal considerations
• Relative axial toot movement The periodontal health of the remaining teeth should
f) Tooth preparation always be optimum before bridgework is commenced and
Initial trends in resin bonded bridges were of non this should be maintained after the bridge is constructed.
preparation. However due to perceptions of increased de- Aspects of bridge design that have implications for the
bonding, preparation of teeth with slots and grooves in periodontium need to be considered, which include
enamel have increased. Preparation results in sensitivity, overcontouring, undercontouring, surface finish, cleansable
caries with undetected de-bonding, difficulty in embrasures, optimum marginal fit, adequate cement lute
temporization, makes removal of bridges difficult and finish and polish, a favourable pontic-soft tissue contact
renders the process irreversible. The very concept of resin and ideal proximal contact points. An over contoured

149 JPDA Vol. 22 No. 02 Apr-June 2013

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

restoration may cause plaque accumulation and gingival Preparation of the retainer surface should be carried
inflammation and the margins should be placed out immediately before cementation using 50um alumina
supragingivally1,20,21. in a sandblaster. Sandblasting helps to increase surface
Good periodontal health is dependent on the patient’s area, form micromechanical undercuts and remove the
ability to control plaque, and restorations should provide oxide layer from the metal surface. Following this, the
optimum access for oral hygiene. Overcontoured metal should be steam cleaned to ensure it is free from
restorations in the embrasure region leave insufficient alumina or metal deposits. Resin cements are the material
room to accommodate an oral hygiene aid. In case of teeth of choice and the cementation protocol for each product
with poor periodontal support when using relative axial should be strictly adhered. Metal alloy resin primers are
tooth movement, splaying of abutment teeth may occur also used in some cement systems (Panavia- Ex, Kuraray
rather than intrusion or compensatory eruption of the Co., Ltd., Osaka, Japan) to couple the adhesion of resin
remaining teeth. Teeth with active periodontal inflammation cement to metal. Isolation with a rubber dam is essential
(gingivitis, periodontitis) render the prosthodontic treatment for the success of all enamel and dentine bonding
almost impossible due to presence of increased fluids and procedures.
bleeding during tooth preparation, impression taking and
restoration fit. CLINICAL CASES
i) Aetiology Of Tooth Loss
The cause of tooth loss or absence can be an important Both the cases presented below were initially screened
factor in successful function of resin bonded bridges. The by a senior clinician and referred to the prosthetic
causes resulting in a need of RBB can be hypodontia, department clinic for restoration of spaces with fixed
extraction due to orthodontic reasons, trauma, caries and prosthesis. The patients were treated within four clinical
its sequelae and periodontal disease. Patients with appointments involving Initial assessment and treatment
hypodontia have deficient enamel for adhesive bonding. planning, tooth preparation and final impression, try-in
Garnett et al4 (2006) in a follow up study of 79 RBB’s and cementation and lastly follow-up. Initial assessment
over a period of eleven years reported 41.1% debonding involved history taking, intra and extra oral examination,
rate. Increase failure rates have been reported5 for trauma radiographic records, alginate impressions, facebow and
patients due to increased dentine exposure and short clinical interocclusal record. In the laboratory, casts were prepared
crowns of abutment teeth. Saddles with increased bone and articulated on a semi-adjustable articulator (Denar)
loss due to periodontal disease result in taller and longer and assessed for abutment position, angulation, mesio-
pontics. This could present the potential for greater non- distal and inter-occlusal saddle space, tissue loss at the
axial forces on the restoration, however, taller abutments saddle (bucco-lingual and vertical) and verification of
also allow for increased dimensions of connectors. Teeth intra-oral findings (Occlusion). Following which a
lost due to and dentition affected by periodontal disease diagnostic wax-up was performed in order to assess and
show differential micr-movement. This could further result plan for the type, design and contours of the planned
in partial de-bonding at one or more abutments with greater restoration. Also custom trays were requested to be ready
individual tooth mobility. at the next clinical visit. Second clinical appointment
j) Fit of framework involved treatment plan discussion, mouth preparation,
A poorly fitting restoration results in plaque final impression ( Dual phase, single stage
accumulation which creates the potential for gingivitis, polyvinylsiloxane; PVS in custom tray), inter-occlusal
periodontitis, marginal leakage, secondary caries, partial record and shade and mould discussion and decision. Third
debond of bridge and complete decementation. Therefore clinical visit included prior to sand-blasting try-in and
it is pivotal that the framework is as accurate a fit to the adjustments, sandblasting and cementation. In both cases
abutment tooth surface as possible. As the thickness of cementation was carried out using; Panavia-Ex, dual
the cement lute increases above the optimum, the bond polymerized resin based cement under rubber dam. Follow-
strength decreases22. In a further study, Chana et al23 showed up appointment involved patient’s feedback, assessment
that bridges constructed using a refractory die technique of occlusion, function, aesthetics and patient adherence to
produce more accurate castings than those where the pattern plaque control.
was lifted off the cast prior to investing. Clinical case A: (Figures 1 & 2) was a 15 year old
k) Cementations procedure female with missing bilateral mandibular premolars due

JPDA Vol. 22 No. 02 Apr-June 2013 150

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

Fig 2: Postoperative image, Fig 5: Postoperative

after fit of fixed-fixed resin occlusal view of resin
Fig 1: Preoperative mandible
bonded bridges bonded bridge restoring
with missing premolar teeth
maxillary first premolar
to hypodontia. The history revealed that the patient had provision of resin bonded bridge for replacement of lost
orthodontic treatment and was at the stage of wearing a maxillary left first premolar. Tooth was lost due to refractory
full-time retainer. The patient was medically fit and well infection and bone loss as a consequence of an endo-perio
with no known allergies and abnormalities. On intra-oral lesion. The mesial abutment ( canine) was un-restored
assessment, the mesio-distal saddle space was for a single and vital and the distal abutment (second premolar) was
unit premolar tooth bilaterally. There was no active disease also vital with an adequate, moderate sized class I occlusal
in relation to soft and hard oral tissues and the direct amalgam. Resin bonded bridge with palatal and partial
restoration present ( class V composite on tooth number occlusal coverage retainers was the treatment of choice
36 and 46) were deemed as optimum on clinical and and was chosen with mutual consent. To obtain a minimum
radiographic evaluation. The occlusion was class-I with of 4mm of connector height the distal proximal surface of
canine guidance bilaterally and absence of posterior canine and mesial of premolar received minimal preparation
interference. The spaces were restored with contemporary for guide planes. The interocclusal space on the palatal
resin bonded bridges to preserve the sound abutment teeth canine surface was created by using relative axial tooth
as implants were contraindicated due to continued growth. movement as described by Dahl24. The inter-occlusal space
After completion of diagnostics the only tooth preparation created was 0.7mm ( the thickness of the retainer) and
carried out was at the proximal surfaces of abutment teeth space closure was complete in 16 weeks with full arch
for guide planes. No tooth preparation was deemed essential contacts.
for occlusal surface of molars and lingual of the canines In the period during which axial tooth movement took
(abutment teeth) due to presence of space after orthodontic place, patient was reviewed every two weeks for carrying
treatment. The design involved coverage of lingual surfaces occlusal adjustments.
of canine and molar including 1/4th of the lingual-occlusal Both patients were delighted with the outcome of
surface as a seating lug. The cementation was done under treatment and are reviewed every six months for detection
rubber dam with Panavia- Ex (Kuraray Co., Ltd., Osaka, of prosthesis related issues specifically, partial de-bonding.
Japan). The cement lute margins were finished and polished DISCUSSION
using shofu rubber wheels followed by diamond polishing
paste on rubber cups using a slow speed motor. The intention of this article is to present the vital factors
Clinical case B: (Figures 3, 4 and 5) illustrates the in success of resin bonded bridges along with a couple of
clinical cases to elaborate on some clinical issues
encountered during treatment. In both the cases the spaces
were restored with RBB’s primarily due to conservation
of dentition and tooth structure. Also the relative
contraindications for this treatment modality (parafuntional
activity, high caries risk, heavily restored abutments, long
span or heavy occlusal loads) were within physiologic
Fig 3: Preoperative image Fig 4: Postoperative image limits. In case B, the presence of class I amalgam restoration
showing buccal view of missing showing buccal view of
maxillary first premolar restored maxillary first did not compromise the adhesive bonding of retainer, as
premolar space with resin there was enough enamel at the mesial marginal ridge and
bonded bridge beyond.
A fixed–fixed RBB was the design of choice, reason

151 JPDA Vol. 22 No. 02 Apr-June 2013

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

being multifactorial. Firstly, cantilever RRB’s, although alumina particles resulting in enhanced bond strengths29.
reported to have higher success rates6 are mostly in case
of anterior saddle areas. Secondly, minimal preparation CONCLUSION
results in reduced tooth reduction than anticipated in cases
of two abutment retained fixed-fixed design. RRB’s are Resin Retained bridge is a viable treatment option for
retained primarily by adhesive bond strength along with replacement of one to two missing teeth in anterior or
the mechanical guide planes. Bond strength is directly posterior regions of the mouth and should always be
proportional to the amount of surface area available for included in the treatment options for indirect restorations.
enamel bonding. In both cases the complete lingual surface These restorations have lower survival rates in comparison
of posterior teeth along with the lingual proximal surfaces to conventional restorations, however they are, conservative
were bonding substrates, resulting in 180° enwrapment. of tooth structure, cost-effective, not needing local
In addition, a mesial occlusal marginal ridge rest seat was anaesthesia administration and reversible in nature with
also utilized to act as a seating stop. Furthermore, complete minimal or no tooth damage on debond. Its longevity is
lingual surfaces of canines in both cases were also bonding supported by increased enamel for adhesive resin bonding,
substrates. This not just increased the retention, but also non mobile abutments, lack of parafunction, rational bridge
resistance form of the metal framework6,14. design, appropriate alloy selection, maximum enamel
Preparation of teeth is not always necessary to create retainer coverage, adequate connector height and meticulous
space for retainers, as space in occlusion may be present clinical technique.
as shown in clinical case A (lingual surface of canine). As
metal can be finished knife edge, no distinct preparation REFERENCES
margins were prepared. The metal framework was designed
to be 1mm short of lingual and proximal gingival margins 1. Cheung GSP, Lai SCN, Ng RPY. Fate of vital pulps
for ease of cementation and cleansability for the patient. beneath a metal-ceramic crown or a bridge retainer.
Space creation at the palatal surface of maxillary canine Intl Endod J 2005; 38: 521–530.
abutment was done using relative axial tooth movment24. 2. Schätzle M, Lang NP,Ånerud A, Boysen H, Bürgin H,
Relative axial tooth movement occurs when a localised Löe H. The influence of margins of restorations on the
appliance or restoration is placed in supra-occlusion, the periodontal tissues during 26 years. J Clin Perio 2001;
occlusion re-establishes full arch contacts over a period 28: 57–64.
of time. This method has been used for creation of 3. Dunne S M, Millar B J. A longitudinal study of the
interocclusal space in cases of tooth wear in combination clinical performance of resin bonded bridges and splints.
with dento-alveolar compensation resulting in loss of Br Dent J 1993; 174: 405-411.
prosthesis space. In a retrospective evaluation25 of the 4. Garnett MJ, Wassell RW, Jepson NJ, Nohl FS. Survival
outcome and factors relating to the creation of localised of resin-bonded bridgework provided for post-
inter-occlusal space, space was created with the use of an orthodontic hypodontia patients with missing maxillary
interim prosthesis that was generally a cemented cobalt lateral incisors. Br Dent J 2006;201:527-534.
chromium appliance. 50 appliances were reviewed in the 5. Creugers N H, Kayser A F, Van‘t Hof M A. A seven-
study and the success rate was 96%. and-a-half year survival study of resin bonded bridges.
Adhesive bond of a cemented RRB involves two J Dent Res 1992; 11: 1822-1825.
substrates (metal and tooth enamel) resulting in two 6. Djemal S, Setchell D, King P, Wickens J. Long-term
interface. On one side, resin cement interacts with the survival characteristics of 832 resin-retained bridges
conditioned tooth enamel, resulting in a highly predictable and splints provided in a post-graduate teaching hospital
bond. On the other side the metal retainer is surface treated, between 1978 and 1993. J Oral Rehab 1999; 26: 302-
mechanically by the use of sandblasting with alumina 320.
particles and chemically using bi-functional metal primers 7. Hussey DL, Linden GJ. The clinical performance of
(Panavia- Ex, Kuraray Co., Ltd., Osaka, Japan) enhancing cantilevered resin-bonded bridgework. J Dent 1996;24:
bond strength26 and increasing survival rates of bonded 251–256.
metal restoration 27,28. Significantly higher bond strengths 8. Boyer DB, Williams VD, Thayer KE, Denehy GE,
have been reported for silicoating procedures, which Diaz-Arnold AM. Analysis of debond rates of resin-
involves sandblasting metal retainers with silica coated bonded prostheses. J Dent Res 1993;72:1244-1248.

JPDA Vol. 22 No. 02 Apr-June 2013 152

 Vohra F, Rashid H. Clinical Success In Resin Bonded Bridges

9. Creugers N H, De Kanter R J A M. Patients’ satisfaction relations of the dentogingival junction in humans. J

in two long-term clinical studies on resin-bonded Periodontol 1961; 32: 261-267.
bridges. J Oral Rehab 2000; 27: 602-607. 21.Ingber JS, Rose LF, Coslet JG. The "biologic width"-
10.Shaw MJ, Tay WM. Clinical performance of resin- -a concept in periodontics and restorative dentistry.
bonded cast metal bridges (Rochette bridges). A Alpha Omegan. 1977;70:62-5.
preliminary report. Br Dent J. 1982;152:378-380 22.Chana HS, Ibbetson RJ, Pearson GJ, Eder A. The
11.Rochette AL. Attachment of a splint to enamel of lower influence of cement thickness on the tensile strength
anterior teeth. J Prosthet Dent 1973; 30:418–423 of two resin cements. Int J Prosthodont 1997; 10:
12.Howe D F, Denehy G E. Anterior fixed partial dentures 340–344.
utilising the acid-etch technique and a cast metal 23.Chana HS, Pearson GJ, Ibbetson RJ. A laboratory
framework. J Prosthet Dent 1977; 37: 28-31. evaluation of the construction of resin- bonded cast
13. Livaditis GJ. Cast metal resin-bonded retainers for restorations. Br Dent J 1997; 183: 130–134.
posterior teeth. J Am Dent Assoc 1980; 101:926–929. 24.Dahl BL, Krogstad O. An alternative treatment in
14.Smyd SE. The role of torque, torsion, and bending in patients with advance localized attrition. J Oral Rehab
prosthodontic failures. J Pros Dent 1961; 11:95–111. 1975; 2: 209-214.
15.Salonga JP, Matsumura H, Yasuda K, Yamabe Y. Bond 25.Gough MB, Setchell DJ. A retrospective study of 50
strength of adhesive resin to three nickel-chromium treatments using an appliance to produce localised
alloys with varying chromium content. J Prosthet Dent. occlusal space by relative axial tooth movement. Br
1994 ;72:582-584. Dent J 1999; 187: 134– 139
16.Latta MA, Naughton WT, Scanlon CF. Bond strength 26.Petrie CS, Eick JD, Williams K, Spencer P.A comparison
of composite to dentin and enamel using self-etching of 3 alloy surface treatments for resin-bonded prostheses.
adhesive systems. Gen Dent 2009 ;57:257-259. J Prosthodont. 2001 ;10:217-223.
17.Saad AA, Claffey N, Byrne D, Hussey D. Effects of 27.Chana H,Kelleher M, Briggs P, Hooper R.Clinical
groove placement on retention/resistance of maxillary evaluation of resin-bonded gold alloy veneers. J Pros
anterior resin-bonded retainers. J Prosthet Dent Dent 2000;83 : 294-300.
1995;74:133-139. 28.Nohl FS, King PA, Harley KE, Ibbetson RJ. Retros-
18.Wise MD, Dykema RW The plaque-retaining capacity pective survey of resin-retained cast-metal palatal
of four dental materials. J Prosthet Dent. 1975 veneers for the treatment of anterior palatal tooth wear.
;33:178-190. Quintessence Intl 1997, 28:7-14.
19.Keenan M, Shillingburg H, Duncanson M, Curtis K. 29.Hansson O, Moberg LE. Evaluation of three silicoating
Wade C.Effects of cast gold surface finishing on plaque methods for resin-bonded prostheses. Scand J Dent Res
retention. J Pros Dent. 1980 ; 43: 168-173. 1993; 101: 243–25.
20.Gargiulo A, Wentz F M, Orban B. Dimensions and

153 JPDA Vol. 22 No. 02 Apr-June 2013