Measure the teeth and cut the Ribbond. Make a pattern by closely adapting a piece of tinfoil or dental floss to the teeth. Tuck the pattern into the interproximal contacts in the same manner as the Ribbond will be adapted
Use cotton pliers to remove the Ribbond from the package and cut to the measured length. Place the cut piece on a clean surface until ready to use.
Prepare lingual surfaces and labial interproximals for bonding. Clean the teeth with a sandblaster or prophy jet or use a diamond burr to roughen the enamel prior to cleaning. Finishing strips should be used to clean the interproximals. Prepare the teeth for bonding in your standard manner (pumice, acid-etch, and apply a thin layer of bonding adhesive).
Optional block-out and stabilization technique: After acid etching, apply a vinyl polysiloxane block-out gingival to the area to be splinted. This stabilizes the teeth during splint construction and makes clean up easier. Photos in these instructions show this block-out technique.
Note: Overhead operatory lights can cause premature setting of light-cured composites. Since the following steps involve light-cured composites, consider turning off the operatory light.
Apply composite in labial interproximals. To reduce the possibility of the teeth rotating and debonding, apply a small amount of tooth shade filled composite to the labial interproximals. Do not force the composite through to the lingual surface. Cure.
Wet the Ribbond with resin. Wet the Ribbond with unfilled bonding adhesive, composite sealant or pit and fissure sealant
and blot off the excess with a lint free gauze or patient bib. The wetted Ribbond may now be touched with powder free gloves or clean fingers. Do not cure yet.
Note: We prefer not to use one-step or fifth-generation resins to wet the Ribbond because these materials contain acids or acetone that must be evaporated. If using these materials, blot off the excess resin with lint-free gauze and then holding the Ribbond with cotton pliers, evaporate the solvent with the air syringe.
Apply filled composite to the teeth. Apply a thin layer of paste-like, medium viscosity, translucent composite resin at the level of the contact area. A Centrix syringe makes application easier. Do not cure yet.
Adapt the Ribbond. Holding the wetted Ribbond with cotton pliers, position one end of the Ribbond against the composite on the tooth. Press the Ribbond through the composite with your finger or an instrument
Adapt the Ribbond in the interproximal contact. To avoid pulling out the Ribbond that has already been adapted, hold the adapted part in position with a finger or an instrument. Place the Ribbond deep into the adjacent interproximal contact with an instrument. Continue until the entire length is adapted. Do not cure yet.
Cover the Ribbond splint with a flowable composite. Using a syringe or an applicator brush, cover the splint with a flowable composite. Make the covering layer as smooth as possible prior to curing.
If a flowable composite is not available, apply a thin layer of filled composite resin over the splint and smooth it with a washed, gloved finger that has been wetted with unfilled bonding adhesive.
Note: If a channel preparation is used, cover the Ribbond with a filled composite resin. Light-cure the covering layer of composite.
Check occlusion, finish and polish. Remove excess composite and polish with a composite-resin polishing paste.
Ribbond does not polish well.
Do not cut into Ribbond fibers.
The finished splint is thin, comfortable and esthetic
Ribbond is perhaps best known for making periodontal splints. Ribbond splints are strong, highly bondable and esthetic. A Ribbond splint takes less time than traditional methods, is more esthetic, less bulky and exceptionally failure resistant.
Ribbond has a well-established and well-documented history of success. For further articles discussing this procedure, including a 96-month recall study authored by Dr. Howard Strassler DMD, FADM, please give us a call.