Matsumura et al.

Int Chin J Dent 2004; 4: 80-84.

Resin-bonded casting used as an anterior fixed partial
denture retainer: A clinical report
Hideo Matsumura, DDS, PhD,a Hiroyasu Koizumi, DDS, PhD,a and Naomi
Tanoue, DDS, PhDb
aDepartment of Crown and Bridge Prosthodontics, Nihon University School of Dentistry, Tokyo,band Department of Specialized Dentistry, Nagasaki University Hospital of Medicine andDentistry, Nagasaki, Japan

This report describes the technique and clinical outcome of an anterior fixed partial denture (FPD)
bonded with two different luting agents. The FPD was fabricated to replace a missing maxillary lateralincisor. The FPD was cast from silver-palladium-copper-gold alloy (Castwell), and the canine retainerand pontic were veneered with indirect composites (Cesead opaque and Dentaclor). The incisor
retainer was primed with a metal conditioner (V-Primer), and seated with tri-n-butylborane initiatedadhesive resin (Super-Bond), whereas the canine retainer was cemented with a glass-ionomer luting
agent (Fuji Ionomer). After an observation period of 10 years, the FPD was functioning satisfactorily.
The adhesive materials and technique reported here are applicable to vital abutment teeth withsufficient enamel bonding area.
(Int Chin J Dent 2004; 4: 80-84.)
Key Words: adhesive, fixed partial denture, noble metal, primer, retainer.

Introduction
Resin-bonded fixed partial dentures (FPDs) are applied to abutment teeth with sufficient enamel
structure. Clinicians frequently encounter FPD cases with both vital and non-vital abutments. For
patients, it is preferable to keep the reduction of sound tooth structure to a minimum during preparationof vital abutment teeth.

Considerable tooth reduction, however, is required in fabrication ofconventional three-quarter, porcelain-fused-to-metal (PFM), and composite veneered cast retainers.
Since the development of a noble metal adhesive system, the use of various types of resin-bonded
retainers and restorations has been reported.1-6
Although the design of retainers varies with many factors, limited information is available about theluting materials, technical procedure, and clinical outcome of such FPDs. This report describes thetechnique and clinical performance of a FPD seated with different luting agents. Also, differencesamong conventional restorations and a resin-bonded retainer are discussed.

Clinical Report
A 48-year-old female patient presented with the complaint of masticatory and esthetic disturbances
as a result of missing maxillary right lateral incisor. On examination, endodontic treatment for themaxillary right canine had been completed. The central incisor adjacent to the missing tooth was
hardly decayed. Several treatment options were proposed: 1) a conventional FPD with tooth-coloredfacing; 2) a resin-bonded FPD with minimal tooth reduction of the central incisor; 3) a removablepartial denture including the posterior missing teeth; and 4) a single-tooth implant. The patient chosethe second of the proposed procedures. The treatment was then explained in detail and consent wasobtained from the patient.

80

Matsumura et al.

Int Chin J Dent 2004; 4: 80-84.

A dowel core made from a silver-palladium-copper-gold alloy (Castwell M.C. 12, GC Corp., Tokyo,Japan; Fig. 1) was seated on the canine with a glass-ionomer luting agent (Fuji Ionomer, GC Corp.).
After examination of occlusion, the area and thickness of tooth reduction were determined. The caninewith dowel core was prepared to form a facing crown abutment. Reduction of the central incisor waslimited to lingual enamel, with a thickness less than 1 mm. An additional retentive hole approximately
1 mm in depth was prepared at the cingulum for stabilizing the retainer as well as for mechanicalretention (Figs. 2-3).
A combined impression of the maxilla was made with addition silicone elastomeric materials(Exafine Putty and Injection, GC Corp.) using a stock tray. A stone cast was prepared and mounted ona semi-adjustable articulator with an opposing cast. The wax pattern of the FPD was fabricated,invested with a cristobalite material, and a metal framework consists of two retainers and a pontic wasthen cast from a silver-palladium-copper-gold alloy (Castwell M.C. 12). The canine metal substructure
was formed for a composite veneered restoration, and the pontic was of a ridge-lap type. The facialsurfaces of the canine retainer and pontic were veneered with a dual-polymerized opaque resin (Cesead,Kuraray Co. Ltd., Osaka, Japan) and an indirect tooth-colored composite material (Dentacolor,Wehrheim, Germany; Fig. 4).
The completed FPD was tried-in, and the inner surface of the canine retainer and the intraoral canine
abutment surface were wiped with an alcohol swab. The inner surface of the incisor retainer (Fig. 5)
was air-abraded with alumina (Hi-Aluminas, Shofu Inc., Kyoto, Japan) using an air-borne particleabrader (Micro Blaster MB102, Comco Inc., Burbank, CA, USA), and conditioned with a single liquidprimer (V-Primer, Sun Medical Co., Ltd., Moriyama, Japan). The incisor enamel surface was etchedwith 40% phosphoric acid (K-etchant, Kuraray Co. Ltd.), washed with water, and air-dried. The FPD
was then cemented with two different luting agents. The canine retainer was seated with glass-ionomer
luting agent (Fuji Ionomer), whereas the incisor retainer was bonded with tri-n-butylborane (TBB)
initiated adhesive resin (Super-Bond C&B Opaque, Sun Medical Co., Ltd.) using a brush-dip technique(Fig. 6).
The patient entered a maintenance program and the FPD was examined regularly.

After anobservation period of 10 years, gingival recession was detected around the canine retainer. The FPD
was functioning satisfactorily without retainer detachment and recurrence of dental caries (Figs. 7-8).

Discussion
Table 1 compares the retainers applicable to vital incisors and canines. The current FPD used aresin-bonded cast retainer to minimize reduction of the vital abutment. In preparation of the central
incisor, local anesthesia was not necessary. If the patient prefers a facing restoration or a three-quarter
restoration as retainer, tooth reduction must be extended to dentin.

In addition, a three-quarter

restoration is apparently inferior in appearance to other restorations (Figs. 9-10).

81Matsumura et al.

Int Chin J Dent 2004; 4: 80-84.

12345678
A canine dowel core to be seated with a glass ionomer luting agent.
Abutment preparation.
A definitive cast. Retentive hole was prepared in the singulum of the central incisor.
Lingual view of the FPD.
After try-in, the surface to be bonded was air-abraded with alumina and conditioned
with the V-Primer agent.
Fig. 6. Facial view. The incisor retainer was bonded with the Super-Bond C&B Opaque resin.
Fig. 7. Facial view of the FPD 10 years after seating.
Fig. 8. Lingual view of the FPD 10 years after seating.
Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.

82

Matsumura et al.

Int Chin J Dent 2004; 4: 80-84.

Surface preparation for resin-bonded retainers is somewhat complicated.

Enamel etching andair-abrasion with alumina are performed to clean the surfaces to be bonded, and to increase the surface
bonding area. Chemical bonding to enamel is facilitated by using Super-Bond resin, which contains acarboxylic adhesive functional monomer (4-META). Bonding to the silver-palladium-copper-gold
alloy is performed by applying V-Primer agent that contains a thione adhesive functional monomer(VTD).7-18

The use of an appropriate resin-based luting agent is indispensable for bonding anon-retentive cast retainer to an abutment surface. Although two different luting agents were used forseating the FPD in the present case, the use of Super-Bond resin alone may also be acceptable.

910Fig. 9. Reduction of central incisor for a three-quarter restoration retainer.
Fig. 10. Unesthetic lingual view of a three-quarter restoration seated on the central incisor.
Table 1. Comparison of retainers applicable to vital incisors and canines.

Tooth reduction
Local anesthesia
Provisional restoration
Surface preparation
ToothCasting
Luting agent
Cementing techniqueAppearance

PFM restoration

Three-quarter restoration Resin-bonded retainer

Considerable
Necessary
Necessary

ModerateNecessary
Necessary

MinimalNot necessary
Not necessary

Not necessary
As castConventional
Easy
ExcellentNot necessary
As castConventional
Easy
Not esthetic

Enamel etching with H3PO4
Alumina-abrasion + Primer
Resin-based
ComplicatedModerate

Regular check-ups are necessary for patients wearing resin-bonded FPD because majority of themissing teeth were extracted by dental caries, marginal periodontitis, and traumatic injury. Considering
the clinical outcome of the FPD in this report, resin-bonded casting may be considered as one of theoptions for an anterior FPD retainer.

References
1. Matsumura H, Atsuta M. Repair of an eight-unit fixed partial denture with a resin-bonded overcasting: a clinicalreport. J Prosthet Dent 1996; 75: 594-6.
2. Monya Y, Matsumura H, Atsuta M. A two-stage resin-bonded fixed partial denture seated in conjunction withpostextraction healing of the alveolar socket: a clinical report. J Prosthet Dent 1998; 80: 4-8.
3. Shimizu H, Takahashi Y. Fixed splinting device to be used without removing adjacent existing cast restorations. JProsthet Dent 1999; 82: 231-2.
4. Shimizu H, Habu T, Yanagida H. Stabilization by splinting of an endodontically treated premolar and a minimallyreduced vital canine with a resin-bonded cast retainer: a clinical report. Int Chin J Dent 2002; 2: 121-5.

83Matsumura et al.

Int Chin J Dent 2004; 4: 80-84.

5. Hikage S, Hirose Y, Sawada N, Endo K, Ohno H. Clinical longevity of resin-bonded bridges bonded using avinyl-thiol primer. J Oral Rehabil 2003; 30: 1022-9.
6. Tanoue N, Yanagida H, Matsumura H. Use of resin-bonded fixed partial dentures as permanent retainers: aclinical report. Int Chin J Dent 2004; 4: 40-3.
7. Atsuta M, Matsumura H, Tanaka T. Bonding fixed prosthodontic composite resin and precious metal alloys with theuse of a vinyl-thiol primer and an adhesive opaque resin. J Prosthet Dent 1992; 67: 296-300.
8. Tanaka T, Kamada K, Matsumura H, Atsuta M. A comparison of water temperatures for thermocycling ofmetal-bonded resin specimens. J Prosthet Dent 1995; 74: 345-9.
9. Watanabe I, Matsumura H, Atsuta M. Effect of two metal primers on adhesive bonding with type IV gold alloys. JProsthet Dent 1995; 73: 299-303.
10. Matsumura H, Tanaka T, Atsuta M. Bonding of silver-palladium-copper-gold alloy with thiol derivative primers andtri-n-butylborane initiated luting agents. J Oral Rehabil 1997; 24: 291-6.
11. Matsumura H, Shimoe S, Nagano K, Atsuta M. Effect of noble metal conditioners on bonding between prostheticcomposite material and silver-palladium-copper-gold alloy. J Prosthet Dent 1999; 81: 710-4.
12. Matsumura H, Taira Y, Atsuta M. Adhesive bonding of noble metal alloys with a triazine dithiol derivative primer
and an adhesive resin. J Oral Rehabil 1999; 26: 877-82.
13. Moulin P, Degrange M, Picard B. Influence of surface treatment on adherence energy of alloys used in bonded
prosthetics. J Oral Rehabil 1999; 26: 413-21.
14. Moulin P, Picard B, Degrange M. Water resistance of resin-bonded joints with time related to alloy surfacetreatment. J Dent 1999; 27: 79-87.
15. Matsumura H, Kamada K, Tanoue N, Atsuta M. Effect of thione primers on bonding of noble metal alloys with anadhesive resin. J Dent 2000; 28: 287-93.
16. Matsumura H, Atsuta M, Tanoue N. Evaluation of two thione primers and composite luting agents used for bonding
a silver-palladium-copper-gold alloy. J Oral Rehabil 2002; 29: 842-6.
17. Kajihara H, Suzuki S, Kurashige H, Minesaki Y, Tanaka T. Bonding abutments to cast metal post/cores:
comparison of pre-treatment effects. J Oral Rehabil 2003; 30: 119-24.
18. Shimoe S, Tanoue N, Yanagida H, Atsuta M, Koizumi H, Matsumura H. Comparative strength of metal-ceramic
and metal-composite bonds after extended thermocycling. J Oral Rehabil 2004; 31: 689-94.

Reprint request to:
Dr. Hideo Matsumura
Department of Crown and Bridge Prosthodontics, Nihon University School of Dentistry
1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
Fax: +81-3-3219-8351 E-mail: matsumura@dent.nihon-u.ac.jp
Received July 30, 2004. Revised August 9, 2004. Accepted September 6, 2004.
Copyright ©2004 by the Editorial Council of the International Chinese Journal of Dentistry.

84