No difference in the 5-year survival rates between the resin-bonded cantilever bridge and the removable partial denture for the restoration of the shortened dental arch

Abstract

This was a randomised controlled trial (RCT) in a dental hospital. Resin-bonded fixed partial dentures (RBFPD) or removable partial dentures (RPD) were compared. The RBFPD restored 1 occlusal unit, up to but not beyond the second premolar, by means of single pontics cantilevered from single abutments whenever possible. Bilateral lower free-end saddle RPD were constructed on cast metal frameworks that incorporated rests, retainers and a rigid connector. The trial's participants were reviewed 3 months and 1 year after insertion of the new lower prosthesis, and thereafter at yearly intervals. Additional review and maintenance appointments were scheduled as clinically required. Survival of the prosthesis was assessed at each review according to specified criteria. Survival analysis was performed using a Cox proportional hazard regression ratio. Eleven fixed partial dentures and 15 RPD failed. Debonding was the most common cause of failure in the RBFPD group, with non-use and loss of teeth most common in the RPD group. Although the RPD group required rather more maintenance visits, the difference in prosthesis survival rates was not statistically significant [hazard ratio (HR), 0.59; 95% confidence intervals (CI), 0.27-1.29]. The absence of a significant difference in 5-year survival, the reported advantages of fixed partial dentures, and the greater maintenance need for those in the RPD treatment group support the use of RBFPD.