Porcelain Fused to Metal Crown as an Abutment of a Metal-Ceramic Resin-Bonded Fixed Partial Denture: A Clinical Report

Abstract

This clinical report describes a conventional resin-based fixed partial denture for a 42-year-old woman to close an edentulous space in the region of the second maxillary premolar. While the first maxillary molar had been crowned with porcelain fused to metal (PFM) system 10 years ago and the first premolar was intact and sound except for a small carious lesion in the distal aspect. The essential clinical and laboratory procedures are illustrated. Multiple clinical studies document excellent long-term success of resin-bonded fixed partial dentures. In the 1970s, the Rochette resin-bonded fixed partial denture (RBFPD) was introduced. Next, to enhance retention and resistance form of posterior RBFPD preparation of parallel guide surfaces on the interproximal aspects of the adjacent teeth along with rests on the occlusal aspects to counteract dislodging forces was recommended. A 42-year-old woman presented with an extracted left maxillary second premolar. The first maxillary molar had been crowned 10 years ago and the first premolar had a small carious lesion in the mid distal of proximal aspect. To eliminate unnecessary cutting of the PFM of the first molar and crown preparation of the first maxillary premolar, the use of RBFPD was suggested and accepted by the patient. This clinical report described the indication, the selection of a PFM-crowned abutment, and clinical procedures involved in the fabrication of RBFPD that provided a conservative solution for replacement of one posterior tooth. RBFPDs can be used successfully in both the anterior and the posterior regions of the mouth to replace one or two missing teeth. However, the survival rate of RBFPDs is still considerably less than that of conventional fixed partial dentures. The principal reason for failure is debonding of the framework from the abutment tooth. The selection of nonmobile abutment teeth, the preparation design that enhances retention and resistance form, and the tooth bonding technique are critical for success.