Akademik Veri Yönetim Sistemi
Uluslararası Adeziv Diş Hekimliği Kongresi, Konya, Türkiye, 1 - 03 Haziran 2023, ss.1
Minimal-Invasive Treatment of Missing Lateral Incisors with Fiber-Reinforced Composite
Bridge
Özge Duman, Pınar Kement, Ahmed Alshawi, Rabia Yıldırım, Ugur Erdemir
Istanbul University Faculty of Dentistry Department of Restorative Dentistry
Keywords: Fiber reinforced bridge, Missing teeth, Direct composite restoration, Minimal
invasive dentistry, adhesion
Introduction,
Missing lateral incisors is one of the most common congenital tooth anomalies. Treatment of
such tooth anomalies in the anterior region, functionally and aesthetically with minimally
invasive methods is very important, especially in patients with incomplete growth.
Case Report,
A-16-year-old female referred by an orthodontist after finishing her orthodontic treatment.
Medical history was clear and clinical-radiographic examination showed bilateral missing lateral
incisors and median diastema. Patient stated that she was not satisfied with the photographs and
afraid to laugh. All treatment options including a removable prosthesis were discussed with the
patient and her parents (due to her age). The decision was to apply fiber reinforced composite
bridge until growth is complete. Button technique was used to determine the suitable resin
composite shade. Rubber-dam was applied and retention grooves of 1 mm depth were prepared
on the palatal surfaces of the abutment teeth. The distance between the retention grooves was
measured with flexible metal tapes and pre-impregnated fiber (Interlig-Angelus) was cutted with
scissors according to the length.
The retention grooves were etched with orthophosphoric acid 35%(3M Scotchbond Universal
Acid); a universal adhesive bond (3M Scotchbond Universal Plus) was then applied and
light-cured. A thin layer of flowable composite (Tetric power-flow Ivoclar) was applied to the
grooves, the fiber strips were adapted to the grooves and light-cured. The retention grooves were
filled with a nano-hybrid composite and composite restorations (Diamond A1,OL and A1-
Kulzer) were made directly in the mouth using the polychromatic layering-technique. The
finishing process was initiated with yellow ring bur and coarse disk (3M-Sof-Lex) to produce the
contours of the teeth followed by silicon polisher. Polishing twist (EVE-Diacomp), diamond
paste with goat-hair brush and felt wheel (Enamel Plus Shiny-Micerium) were used after
occlusion adjustment.
Conclusion,
Although fiber-reinforced composite bridges are initially considered as a temporary method for
the restoration of missing anterior teeth, it can also be applied as a permanent restoration in
correctly selected cases due to its minimal invasive and simplicity. After 6-months of follow-up
the periodontal health was very good, no color change was observed, and the patient was
satisfied with the treatment results.