Overview: Dandy’s temporary polymethyl methacrylate (PMMA) bridges are digitally fabricated restorations designed for provisional dental support. This guide provides instructions for clinicians on the indications, risks, and maintenance of PMMA bridges.
Indications and Clinical Use
PMMA bridges are used to provisionally restore dentition that is worn, broken, or aesthetically unpleasing.
Primary Functions
Tooth Replacement: Spans edentulous spaces to replace missing permanent teeth using support from natural teeth or implants.
Stability: Provides occlusal stability and maintains proper relationships between dental arches.
Restoration Preview: Offers a preview of the final dental restoration for the patient.
Contraindications
Clinicians should use temporary PMMA bridges with caution in patients with the following conditions:
Uncontrolled periodontal disease.
Severe bone resorption.
Active caries or oral lesions.
Patient Risks and Benefits
Clinicians must advise patients of the specific risks and benefits associated with temporary PMMA bridges.
Potential Risks
Failure or Breakage: The bridge may experience misfit, breakage, or failure during use.
Tissue Irritation: Localized irritation of oral tissues may occur based on individual patient variability.
Recurrent Caries: New decay may form around the margins of the restoration.
Potential Benefits
Improved comfort and aesthetic appearance.
Enhanced speech and chewing capabilities.
Better digestion due to improved chewing function.
Fitting and Cementation Procedures
Proper fitting ensures the longevity and comfort of the PMMA bridge.
Initial Fitting Steps
Test the fit of the PMMA bridge to ensure adequate aesthetics.
Inspect the margins to ensure the bridge adapts properly to the preparation.
Use articulating paper to identify and adjust high spots on the restoration.
Reline the bridge with acrylic if the fit requires modification.
Final Cementation
Clean the restoration and the preparation site thoroughly.
Apply a provisional cement to the bridge.
Clean all excess cement from the surrounding tissue once the cement has set.
Technical Adjustment Recommendations
Clinicians must use specific tools to prevent damage to the PMMA material during adjustments.
Cooling and Speed Requirements
Operate the dental bur at high speeds.
Apply minimal pressure and use continuous water and air spray to prevent micro-fractures.
Avoid using air-only handpiece adjustments.
Recommended Adjustment Tools
| Surface Type | Recommended Bur |
|---|---|
| Occlusal and Lingual (Anterior) | Football-shaped bur |
| Buccal and Lingual | Tapered bur |
| General Adjustments | Fine-grit diamond bur |
Post-Procedure Maintenance
Educate patients on daily hygiene and dietary habits to maintain the integrity of the bridge.
Daily Oral Hygiene
Brushing: Brush teeth twice daily using a soft-bristled toothbrush and fluoride toothpaste.
Flossing: Use a floss threader daily to clean around the bridge without dislodging the restoration.
Mouthwash: Avoid alcohol-based mouthwashes as they may increase plaque buildup.
Dietary Restrictions
Limit hard, crunchy, or sticky foods that could loosen the bridge.
Avoid sugary foods that promote decay at the restorative margins.
Disposal and Sustainability
PMMA dental restorations must be disposed of according to environmental guidelines.
Prohibited Disposal Methods
No General Trash: Do not place PMMA waste in regular garbage or standard medical waste streams.
Recommended Disposal Methods
Chemical Recycling: Use specialized dental waste handlers to chemically break down PMMA into its monomer (MMA).
Plastic Management: Treat fully cured PMMA as general plastic waste if it is not contaminated with hazardous materials or metals.