Direct Resin-Fiber Pontics for Missing Laterals

Introduction to the case

I had a patient yesterday that came in for recall, CC that her flipper was broken. She has congenitally missing laterals #7/10 and originally came to my office for repair of an older flipper, which we did, and after it broke again we made her a new one. That one lasted about 2 year before it also broke.

She had planned on just having the flipper repaired again, but after discussing her options, she was sick of wearing it and always having it break, so we elected to do a bonded bridge.

This is my first direct attempt at this, but I’d seen a few case reports on the technique, along with all the great posts on here, so I had a pretty good idea of how I wanted to approach this.

I apologize for the poor photos, I’m using a 10 year old point and shoot camera and since this was unplanned we didn’t have a lot of time for perfect shots. I’d love some feedback on shade, contour, etc., as compared to what I see by some of the docs on here this look like chiclets.

Started by taking an alginate and doing a quick wax-up over lunch. Pt approved and we got to work. Began by bonding Fiber-Splint ML by Polydentia for added strength and to act as a framework to build off. I don’t love the stuff and the fiber-glass tends to come apart after you cut it and soak in BA, but it’s all we have. Used a putty mold from the wax-up to establish the incisal edge. Composite used was Filtek SU A3D (dentin) and A2E (enamel). Polished w/ brownie and rubber cup.