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Endodontics

Ribbond: Chairside- fabricated FRC post & core procedure (bondable reinforcement ribbon)

Authors: Dr. Manisha V. Dixit, Dr. Vighnesh S. Dixit.
M. A. Rangoonwala College of Dental Sciences & Research, Pune, Maharashtra.

Introduction:
It is single sitting, resilient, esthetic, bondable post and core system. It is made of ultrahigh molecular weight polyethylene fibres. High molecular weight enhances the bondability, whereas cross- link lock stitch makes the increased toughness. It is translucent, partially white in colour, and biocompatible.
Available in three sizes-
Ribbond 1.18mm (thick) }post and core
Original Ribbond 0.35mm } post and core
Ribbond triaxial 0.5mm reinforcement of pontics.

Case Report:
A 15-year-old female patient reported to the department of Conservative Dentistry & Endodontics with broken,discolored maxillary left central incisor ; having history of traumaseven years back.
The initial clinical examination did not reveal any soft tissue pathology. Radiographic examination confirmed coronal fracture of maxillary left central incisor, with apical resorption. Tooth was tender to percussion with mobility within normal physiologic units.
After cleaning & shaping the root canals, a 3mm apical plug of MTA (mineral trioxide aggregate- Pro-root; Dentsply) was placed. Followed by sectional obturation with gutta percha.

Intraradicular rehabilitatoion iwth bondable reinforcement ribbon Ribboned: Chairside-Fabricated FRC Post & Care
Preoperative-photograph-wit
Preoperative photograph with discolored max. left central insicor. H/O trauma seven year back.

Technique:
  1. A countersink was made at the opening of the canal with rounded angles.
  2. Depth of the prepared canal was measured and ribbon piece atleast twice the length is cut. Two or three ribbon pieces were required.
  3. The canal was etched for 15 seconds, dried and primer and adhesive were applied.
  4. Ribbond was wetted with unfilled adhesive resin. Excess was blotted off with gauze.
  5. Dual cure composite was injected into the canal. Ribbond was held with the help of cotton pliers and centered over the canal opening. Instrument was used to push it to the apical end of the post space. As required an additional piece of Ribbond was inserted between protruding ends of first piece. Second piece was required to produce greater density of Ribbond at the post- core junction. Post space was completely filled with maximum number of ribbons and ends of ribbons were folded back into the canal.
  6. Free ends of Ribbond emerging from the canal were used to form core. A mass of filled composite was placed between the emerging ends of Ribbond. One end was folded back into the canal with cotton pliers and other ribbons were compressed against the walls of coronal opening. Ribbond and composite were arranged roughly to the shape of core and were cured. Core build- up was completed with filled composite resin.
  7. Ribbond was finished or shaped with diamond rotary instruments for crown preparation of Porcelain-fused to metal crown.

After-etcching Post-oprerative-view
After etching, bonding & application of dual cure resin cenent, fiber rienforced ribbons inserted into the post space. Post space completely filled with maximum no.of ribbons. End of ribbons folded badk into the canal.

Core-buildup-with-light-cur Post-space
Core buildup with light cure composite resin. Crown preparation for PFM crown Post operative view

A similar such case, for 27-year-old male patient reported to the department of Conservative Dentistry & Endodontics with broken,discolored maxillary left central incisor ; having history of traumafive years back is also presented.

Conclusion:
Based on these clinical cases, bondable reinforcement ribbon presents a suitable single visit option for restoration of aesthetics and function.

References:
  1. David N. Rudo: Ribbond, Bondable reinforcement ribbon, Applications and techniques, Edition no. 13, www.ribbond.com.
  2. Dr (Mrs) K. K. Wadhwani et al: A clinical study on non- metallic fiber reinforced post- core, www.jcdonline.org, Pg. 161- 167.
  3. Freedman G. A., Esthetic post and core treatment, DCNA Vol. 45, No.1, Jan 2001.
  4. Goodacre C. J. and Kan J. Y. K.: Restoration of the endodontically treated tooth, Endodontics, Fifth edition, 913- 950, Edited by Ingle J. L. and Bakland L. K. 2002.
  5. Potashnick S. R. and Weine F. S.: Restoration of the endodontically treated teeth, Endodontic therapy,Weine, Fifth edition.
  6. Qualtrough AJE, Mannoci F.: Tooth- coloured post system : a review, Operative Dentistry, 2003, 28, 86- 91.
  7. Trabert K. C. and Cooney J. P.- The endodontically treated teeth, Restorative concepts and techniques, DCNA Vol. 28, No.4, Oct. 1984.
  8. Wagnild G. W. and Mueller K. I.: Restoration of the endodontically treated tooth, Pathways of pulp, Eighth edition, 765- 794,

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