Puente adhesivo en paciente con labio leporino y fisura velopalatina: una solución temporal con compromiso estético / Adhesive bridge in a patient with cleft lip and palate: a temporary solution with esthetic commitment

En la actualidad el aumento de la demanda estética y la necesidad de procedimientos mínimamente invasivos ha llevado a un aumento de la técnica adhesiva. Ribbond® es una marca de fibra de polietileno que permite un eficiente traspaso de fuerzas, es virtualmente plegable y se adapta fácilmente a la morfología dentaria y al contorno del arco dentario. Dentro de sus principales características podemos encontrar: Biocompatibilidad, inerte, translúcido y durable. Dentro de la odontología se le han dado distintos usos para esta fibra, ya sea como mantenedor de espacio, puente adhesivo, poste y núcleo endodóntico, ferulización, restauraciones tipo inlay y estabilización postortodóncica. En el caso de los pacientes fisurados se ha hecho relevante el uso de Ribbond® como puente adhesivo ya que permite mejorar la estética y rehabilitar temporalmente los espacios desdentados causados por la ausencia de un incisivo, principalmente una vez terminado el tratamiento de ortodoncia y en espera de una rehabilitación definitiva, aún más cuando el paciente no ha terminado su crecimiento y desarrollo. En este artículo se presenta un caso clínico de un paciente con labio leporino y fisura velopalatina operado demostrativo de la técnica de rehabilitación con Ribbond®.

Today the increasing demand of aesthetic and minimally invasive procedures has led to a boom of the adhesive technique. Ribbond® is a polyethylene fiber that allows an efficient transfer of forces, is virtually foldable and is easily adapted to tooth morphology and dental arch contour. Among its main features we can find: Biocompatibility, inert, translucent and durable. In dentistry, different uses have been given to this fiber, whether as space maintainer, adhesive bridge, endodontic post and core, splinting, inlay type restorations and postorthodontic stabilization. In the case of cleft lip and palate patients the use of Ribbond® as an adhesive bridge has become relevant, as it improves aesthetics and temporarily rehabilitates the edentulous spaces caused by the absence of an incisor. It is used especially after completion of the orthodontic treatment and waiting for a final rehabilitation, even when the patient has not completed their growth and development. This article presents a clinical case of a patient with lip and cleft palate operated with the rehabilitation technique using Ribbond®.

A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study.

Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10). Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01) Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored maxillary premolars can help preserve the fracture resistance of teeth.

Ribbond as an esthetic space maintainer.

Ribbond is a biocompatible, esthetic material made from a highstrength polyethylene fiber. Lenowoven polyethylene ribbon (Ribbond) has been used successfully for tooth splinting, replacement of missing teeth, reinforcement of provisional acrylic resin fixed partial dentures, and orthodontic retention. This paper presents the application of this polyethylene ribbon - RIBBOND as an esthetic space maintainer in pedodontic practice. We suggest that this combined technique of polyethylene fibers and composite material could be very efficient alternative procedure to conventional unesthetic space maintainers in pedodontic practice with excellent esthetics and functional results.

Endodontic and prosthetic treatment of teeth with periapical lesions in a 16-year-old-girl

This paper reports the nonsurgical endodontic therapy using calcium hydroxide intracanal dressing and prosthetic treatment of 9 teeth with periapical lesions in a 16-year-old female patient. The periodontal treatment plan included oral hygiene instructions, mechanical debridement and gingivectomy in the maxillary incisors to improve gingival contouring. Root canal treatment was indicated for teeth 11-13, 21, 22, 42-45. After successive changes of a calcium hydroxide intracanal dressing during 6 weeks, the size of the periapical radiolucencies decreased and lesion remission occurred after root canal obturation. The endodontically treated teeth received a bondable polyethylene reinforcement fiber (Ribbond) in the prepared canal space and crown buildup was done with composite resin. Prosthetic rehabilitation was planned with single-unit metal-ceramic crowns and fixed partial dentures. Clinical and radiographic evaluation after 6 months showed successful results. The outcomes of this case showed that chronic periapical lesions can respond favorably to nonsurgical endodontic treatment in adolescent patients and that, with proper indication, polyethylene fibers can provide an effective conservative and esthetic option for reinforcing endodontically treated teeth undergoing prosthetic rehabilitation.