Hydraulic and Hydrophobic Impressions

(Continued)

Sculpture/FibreKor Inlay Bridge

With the Sculpture/FibreKor system (Jeneric/ Pentron), you can replace missing teeth with minimal reduction of the adjacent abutment teeth while producing maximum aesthetics. Most patients demand the ultimate in aesthetics while demanding minimally invasive treatment. The Sculpture/FibreKor system enables the dentist to accomplish both these objectives.

Conventional porcelain fused to metal bridges can produce highly aesthetic results under certain circumstances. However, conventional tooth preparation for this kind of restoration involves major and irreversible tooth reduction which may occasionally result in the need for root canal treatment or periodontal surgery. Moreover, in cases where there is a metal margin on the facial, if the gingiva later recedes, the patient may develop "black line disease" where the metal margins become exposed. This becomes a very difficult aesthetic problem.

The Sculpture/FibreKor system can often resolve all of these problems. In many cases, the use of this system involves removing just enough tooth structure to produce an inlay retainer. And the aesthetics are incomparable. In this article we describe one case where the use of the Sculpture/FibreKor system produced remarkably good aesthetics with minimal amount of tooth reduction and chair time. than four minutes.

Clinical Case

A handsome, upwardly mobile 34-year-old male presented with a failing resin-bonded bridge replacing a missing mandibular premolar (Figure 10). The patient had never been entirely satisfied with this prosthesis because of the amount of metal that showed. He wanted the quadrant to be restored to its previous natural look.

Figure 10

We presented a treatment plan using an inlay retained Sculpture/FibreKor bridge to replace the failing resin-bonded bridge. Conservative inlay retainer preparation would be done on the mesial of the first molar and the distal of the premolar. This treatment plan would respect his concerns about minimal tooth reduction while providing maximum aesthetics.

A pre-operative impression was made using 30-Second Blue Velvet (J. Morita), a bite registration material. This would later be used as a matrix to make a provisional bridge. The resin-bonded bridge was easily tapped off with the ATD Bridge Remover (J. Morita). This system utilizes a flexible metal cable which is inserted under the pontic and attached to the hammer mechanism.

Removal of the failing resin-bonded bridge revealed extensive carious enamel and dentin around and under the metal wings and rest seats. These areas were stained with Caries Detector (J. Morita) to ensure adequate detection (Figure 11). All carious dentin and enamel were removed. The second premolar was then prepared as though it were to receive an MO inlay. The path of insertion was perpendicular to the occlusal plane and in line with the long axis of the tooth. The axial walls were each flared out 10 degrees from the vertical. All the internal line angles were rounded. No bevel was placed on any of the cavosurface margins. The finish line was a deep chamfer. For ideal resistance, the occlusal reduction should be at least 2-2.5 mm deep. The buccolingual width of the proximal box should be at least 2 mm as should the buccolingual. width of the occlusal cavity preparation. The isthmus should not be as narrow as for a gold inlay preparation.

Figure 11

The distal of the premolar was prepared as though it were to receive a DO inlay. The path of insertion of this inlay preparation was aligned with that of the MO inlay preparation in the molar so that they would both be parallel.

After the preparations had been completed, Liner Bond 2V was applied to all surfaces of the cavity preparations and light cured. The purpose in doing this was to seal the open dentinal tubules to increase patient comfort and reduce post-operative sensitivity. Another advantage with this technique is that when the patient returns for cementation of the permanent fixed partial denture, it will not be necessary to administer local anesthesia since the dentinal tubules will already have been sealed (Figure 12).

Figure 12

A final impression was made using a quadrant arch, double arch tray utilizing the hydraulic and hydrophobic impression technique.

The preliminary impression was made after the teeth had been prepared for the Sculpture/FibreKor bridge. Next, 30-Second Blue Velvet was loaded onto both sides of a tray and inserted into place. The patient closed into MI and held that position until the material had set (Figure 13 and 14).

Figure 13

Figure 14

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