Fiber-reinforced bridges: first contact

When I started my private practice over a decade ago, I realized my service portfolio had a gap.

On many occasions, patients came to my office needing a permanent or temporary replacement for a missing tooth, for various reasons. You might think, "But Doctor, there are many ways to replace missing teeth," and you'd be right. However, the options we have have remained practically the same as always: removable dentures, dental implants, and conventional bridges with their variations. Although each treatment has its indications, pros, and cons, in many cases, when I put myself in my patients' shoes, I ended up convinced that I wouldn't recommend any of these options to myself.

I thought, “Conventional bridges sacrifice almost 70% of the healthy tooth structure of the abutment teeth, significantly reducing their structural integrity and compromising their vitality. Removable braces are uncomfortable and often carry an unpleasant psychological burden for patients. While dental implants are a great solution, they sometimes cannot/should not be done at a particular point in the patient's life. The treatment takes several months, and sometimes invasive procedures are required, which many patients are unwilling to undergo, not to mention the high cost of these treatments.”

The treatment I envisioned had to be able to be done directly with the materials I had in my office. This way, it would be practical and low-cost, since I wouldn't have to add the lab fee. The bridge had to have adequate structural strength to perform its chewing function properly, it had to be adhesively bonded to the abutment teeth to minimize its invasiveness, I wanted the bridge to be easily repairable, and finally, but no less importantly, it had to be aesthetically pleasing.

Fig 1: Framework (structure) for a fiber-reinforced bridge, in this case made with unidirectional glass fibers, GranTEC by VOCO

He also pursued the idea that this bridge, if used in the anterior sector, could be modified throughout the patient's life, allowing for aesthetic dynamism in color and shape without the need to completely change the work.

I always knew that composite resin was my best ally, however I lacked the material that would provide the structure to the bridges, it was in the search for this material that I discovered reinforcing fibers (as I call them) or by their English name Fibre Resin Composites.

To my surprise, a friendly dental supply company was importing Ultra High Molecular Weight Polyethylene fibers, and that's when the adventure began.

I acquired fibers of different materials and brands and studied the proposed techniques for fabricating bridges. This allowed me to create my first clinical cases, thinking, "What could possibly go wrong?"

This project has now been going on for 13 years, and I can say it has been both wonderful and challenging. I completed my postgraduate research thesis on this topic, where I developed scientifically supported clinical protocols aimed at achieving the greatest possible longevity for bridges, whether as definitive prostheses or long-term provisional restorations. These protocols employ my own techniques, which are easily reproducible and can be achieved with the most common instruments and materials found in dental offices.

Now you know a bit about the history of these bridges and some of their advantages. If you enjoy working and experimenting with dental materials, you'll love Fiber Reinforced Bridges. Let's stay in touch.

I hope you find this information useful, best regards!

Dr. Marvin