This course describes the necessary step-by-step clinical and laboratory procedures that produce the CBW® appliance. This course also describes situations where the CBW® appliance can be used in conjunction with conventional treatments.

Upon completion of this course, participants should be able to do the following:

1. Understand the concept of Crownless Bridge Works (CBW®) as a bridge facility without conventional crown preparations.
2. Become familiar with the necessary step-by-step clinical and laboratory procedures to fabricate and place Crownless Bridge Works.
3. Discuss the practicality of the Crownless Bridge Work technique.
4. Understand the concept of a CBW® framework.
5. Describe treatment situations in which the CBW® technique could be used in conjunction with conventional treatment modalities.
6. Answer frequently asked questions about the CBW® technique.

The Crownless Bridge Work method is a combination of dental techniques based on more than 20 years of clinical experience in the field of both adhesive dentistry (etched bridges) and bridge-anchoring systems. Both techniques have been used and documented widely over the past few decades. In general, the CBW® bridge system combines the advantages of both techniques. It addresses two prevalent problems in the replacement of missing teeth using fixed bridge prostheses. First, a large percentage of edentulous areas in the posterior region of the mouth are not restored. Second, patients are reluctant to have healthy teeth ground down in order to fit a conventional bridge. CBW® presents a new and exciting alternative to the conventional fixed bridge replacement. This technique uses a combination of pin-anchoring and adhesive fitting and has a number of advantages over resin-bonded bridges and conventional bridges. This course will introduce the technique, describe the step-by-step clinical and laboratory procedures necessary to produce the CBW® appliance, and describe situations in which the technique can be used in conjunction with conventional treatments.

1. Introduction
   
   
2. Advantages of the CBW Technique
   
   
3. Treatment Procedure
   
   
   1. Diagnosis
      
      
   2. Pouring study model (laboratory procedure)
      
      
   3. Parallel leveling of abutments
      
      
   4. Preparation of anchor channels
      
      
   5. Fitting and cementing CBW anchors
      
      
   6. Impression
      
      
   7. Production of the working model (laboratory procedure)
      
      
   8. Waxing the framework (laboratory procedure)
      
      
   9. Casting procedure (laboratory)
      
      
   10. Fitting the CBW framework
       
       
   11. Cementing the CBW bridge
       
   
   
4. CBW Framework Concept
   
   
   
   
   1. Anterior bridges
      
      
   2. Posterior bridges
      
      
   3. Replacement of molars in mandibular arch
      
   
   
5. Options for the CBW Technique
   
   
   
   
   1. Composite restorations
      
      
   2. Combinations with conventional crowns
      
      
   3. Cast restorations
      
      
   4. CBW zirconium anchors with ceramic pontics
      
   
   
6. Frequently Asked Questions
   
   
7. Case Reports
   

1. Minimalinvasive Buckenprothetik: Crownless Bridge Works (CBW), Dr. med. dent. W. Olschowsky, Die Quintessenz 9, 917-929,1998
2. Zahntechnische Arbeiten in Verbindung mit CBW-Ankern (CBW-Crownless Bridge Works), E. Frank ZTM, Das internationale Zahntechnik Magazin, 7-8, 410-415, 1998
3. In-vitro Resistance of a Novel Miniature Anchor System for Tooth Replacement against Loading, Dr. H.M.A. Keltjens, Prof. Dr. N.H.J. Creugers, Universitat Nijmegen, NL, (in press.) I.A.D.R. (International Association Dental Research) Kongref3vortrag Nizza 24-27. Juni 1997
4. Composite to metal bond strength: effects of various sureface, M.A. Vargas, D.S. Cobb and T.A. Fridrich, J. Dent. Res. 76, 312, Abstr.-Nr. 2387, 1997
5. Intraorales Silikatisieren von Meta llrestaurationen, R. Richter and H. Kuretzky, Clinical Research 11, 1-27, 1997; Produktdossier Co Jet, Espe, Seefeld.
6. Maximum likelihood estimate for the lifetime of bonded dental prostheses, De Rijk WG Wood M, Thompson VP, J. Dent. Res. 75: 1700-1705, 1996
7. A multi centered clinical study of posterior resin-bonded bridges the "Manchester trial", Kellet M, Verzijden CWJGM, Smith GA, Creugers NHJ, J. Dent. Res. 22: 208-212, 1994
8. A meta-analyses of two different trials on posterior resin-bonded bridges, Verzijden CWJGM, Creugers NHJ, Van 't Hof MA, J. Dent. Res. 22: 29-32, 1994
9. Studie zur Anwendung alternativer Fugetechniken von Edelstahledrahten and edelmetallfreien Legierungen unter besonderer Berucksichtigung des Silicoaterverfahrens, A. Nagler and W. Olschowsky, Zahnmed. Diss., Jena, 1994
10. Het Universal Dental Anchorage-systeem, Prof. Dr. I. Naert and C. Janssen, University of Leuven, Belgium, 1993
11. Das Universal Dental Anchorage-System - eine Alternative zur konventionellen Bruckentechnik, Dr. E. Parsche, Dr. R.O. eratschko, University of Graz, Austria, Phillip Journal 9, 383, 1993
12. A seven-and-a-half year survival study of resin-bonded bridges, Creugers NHJ, Kayser AF, Van "t Hof MA, J. Dent. Res. 71: 1822-1825, 1992
13. Kleben and Klebetechniken, Teil 2., R. Janda, Dent. Labor 40, 615?628, 1992
14. Silikatisieren als Oberflachenkonditionierung von Metallen fur den hydrolysebestandigen Verbund mit Kunststoffen, W. Beldner, Die Quintessenz 43, 103-115, 1992
15. Universal Dental Anchorage. Die Moglichkeit der LOckenversorgung ohne zu beschleifen. Die Zahnarztwoche 9/1992
16. Universal Dental Anchorage - dentaal alternatief - Dr. Chr. Hartendorp, Dr. M.Th. Olieslagers, NT 11, The Netherlands, 1992
17. An analyses of clinical studies on resin-bonded bridges, Creugers NHJ, Van't Hof MA, J. Dent. Res. 70: 146-149, 1991
18. An alternative method of canine fixed partial denture retainers, Prof. T. Wilwerding, Creighton University School of Dentistry, Omaha U.S., Quintessence International Vol. 21, 1990
19. Een tandsparend alternatief, Prof. Dr. N.H.]. Creugers, Dr. R.M.J.G. Sangen, University of Nijmegen, The Netherlands, Tandartspraktijk, 18-23, 11.JG., 7/8, 1990
20. Das Universale Dentalankersystem zur Versorgung kleiner Lucken, Prof. Dr. H. Schwickerath, Dtsch. Zahnarztl. Z. 43, 469, 1989
21. A survey of clinical experiences with dental-anchoragebridges of general practising dentists (1 to 6 years), Dr. J.G. Berkhof, Dr. S.H. Lo, University of Groningen, The Netherlands, 1989
22. Bonded bridge recalls and Weibull distributions, results averaging seven years, Thompson VP, Wood M, De Rijk W, J. Dent. Res. 68: 920, 1989
23. Die Verbundfestigkeit des Universal Dental Anchorage Bruckenankersystems nach Temperaturwechselbelastung and seine Festigkeit unter besonderer Berucksichtigung gekurzter Ankerstifte, R. Funken (Prof. Dr. H. Schwickerath, Prof. Dr. R. Voss), Inaugural Dissertation, University of Cologne, 1988
24. A clinical evaluation of the Universal Dental Anchorage, Jerry Hart, DDS, MS, University of Kansas, 1988
25. Uancoraggio universale per ponti senza corona in odontoiatria generale a in implantologia, Prof. Dr. G. Muratori, Odontostomatologia & Implantoprotesi nr.7 96 111, Italy, 1987
26. An alternative method of tooth replacement, Prof. Dr. C.L. Davidson, Prof. Dr. T.L. Hansson, Drs. C.A. Krabbendam, University of Amsterdam, The Netherlands, Quintessence International Vol. 18, 139, 1987
27. Das mehrfunktionelle Ankersystem, Prof. Dr. S. Sandhaus, Switzerland, Die Quintessenz 4,1985
28. Elektrisches MeBverfahren zur Bestimmung der Belastbarkeit des Unterkiefers bei Patienten mit vollbezahntem