Fiber reinforced composite resin systems.

The Targis/Vectris and Sculpture/FibreKor systems were devised to create a translucent maximally reinforced resin framework for fabrication of crowns, bridges, inlays, and onlays. These materials are esthetic, have translucency similar to castable glass-ceramics such as OPC and Empress, and have fits that are reported to be acceptable in clinical and laboratory trials. These restorations rely on proper bonding to the remaining tooth structure; therefore, careful attention to detail must be paid to this part of the procedure. Cementation procedures should involve silane treatment of the cleaned abraded internal restoration surface, application of bonding agent to the restoration as well as the etched/primed tooth, and finally use of a composite resin. Each manufacturer has a recommended system which has been tested for success with its resin system. These fiber reinforced resins are somewhat different than classical composites, so not all cementation systems will necessarily work with them. Polishing of the restoration can be accomplished using diamond or alumina impregnated rubber wheels followed by diamond paste. The glass fibers can pose a health risk. They are small enough to be inhaled and deposited in the lungs, resulting in a silicosis-type problem. Therefore, if fibers are exposed and ground on, it is extremely important to wear a mask. Also, the fibers can be a skin irritant, so gloves also should be worn. If the fibers become exposed intraorally, they can cause gingival inflammation and may attract plaque. The fibers should be covered with additional composite resin. If this cannot be accomplished, the restoration should be replaced. The bulk of these restorations are formed using a particulate filled resin, similar in structure to conventional composite resins. Therefore, concerns as to wear resistance, color stability, excessive expansion/contraction, and sensitivity remain until these materials are proven in long-term clinical trials. They do hold the promise of minimizing tooth reduction and may be particularly useful in preserving sound tooth structure. Although not the primary intended use, an excellent application is long-term temporization, such as for patients requiring full mouth rehabilitation. The belleGlass/Connect, Ribbond, and GlasSpan materials rely on nonimpregnated polyethylene fibers which have mechanical properties inferior to Vectris and FibreKor. These fibers may be used to greater success as splinting materials, in provisional restorations, and in repair of complete and partial removable dentures.