The Carolina Bridge
The Carolina bridge is a novel all-porcelain bonded pontic. It requires no significant tooth preparation, making it an outstanding option as an interim prosthesis.
Numerous bonded bridge designs have been advocated over the years for the temporary or permanent replacement of missing teeth. Both metal and all-porcelain designs of bonded bridges are popular, each with varying degrees of success.
All of these designs involve some degree of tooth preparation, which makes them irreversible in nature. This is where the Carolina bridge comes in. The key to success with a Carolina bridge is the availability of adequate surface area interproximally to ensure optimally strong resin composite connectors.
Utilizing an ultraconservative all-porcelain bonded bridge for the interim replacement of single incisors relies on clear understanding of indications, contraindications, and clinical technique.
I Love the Carolina Bridge & Here’s Why
The Carolina type of bonded bridge provides benefits like ease of placement, esthetic vitality (no metal substructure), ease of connector repair, and a totally reversible nature.
Patients best suited for an all-porcelain bonded Carolina bridge are young adolescents with missing maxillary incisors. In these cases, an all-porcelain bonded pontic is an excellent interim prosthesis because of its totally reversible nature.
The abutment teeth can be returned to their original condition simply through removal of the bonded pontic and the resin composite connectors.
The Carolina bridge can also be used as a restorative alternative in cases where a more permanent fixed prosthesis is impractical or unaffordable. This might be a result of the patient’s age, medical condition, or economic status.
Additionally, patients with missing lateral incisors and in whom the remaining edentulous space is too small for an implant are often excellent candidates for an all-porcelain bonded pontic of this type. By slightly lapping the adjacent teeth, an esthetically acceptable prosthesis can be obtained.
In my next blog, I’ll talk about the design of the Carolina bridge and illustrate my technique for implementing it in appropriate cases.
Dr. Heymann will be a featured lecturer at the Pankey 2018 Annual Meeting in Nashville, TN
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About Author
Dr. Heymann is particularly active in the clinical research of esthetic restorative materials and participates in a dental practice devoted largely to esthetic dentistry. He is a member of the Academy of Operative Dentistry, the International Association of Dental Research, and is past-president and a fellow of the American Academy of Esthetic Dentistry. He is also a fellow in the International College of Dentists, the American College of Dentists, and the Academy of Dental Materials. He also serves as a consultant to the ADA. The author of more than 190 scientific publications, Dr. Heymann is co-senior editor of Sturdevant's Art and Science of Operative Dentistry and the editor-in-chief of the Journal of Esthetic and Restorative Dentistry. He has given more than 1,400 lectures on various aspects of esthetic dentistry worldwide and has received the Gordon J. Christensen Award for excellence as a CE speaker. Dr. Heymann graduated from the University of North Carolina School of Dentistry. He is past chair and graduate program director of the department of operative dentistry and currently is the Thomas P. Hinman Distinguished Professor of Operative Dentistry at the UNC School of Dentistry
Good after Dr Heymann,
Do you recommend a certain dental lab that has experience with this type of bridge? I have a teenage patient missing #10 that this technique sounds perfect for restoring his smile.
Thank you,
Dr Shrenna l Clifton
Shrennalclifton@gmail.com