Secure and precise insertion of minimally invasive resin-bonded fixed dental prostheses after ridge augmentation by means of a positioning splint.

Abstract

Single-retainer resin-bonded fixed dental prostheses (RBFDPs) are described as an excellent minimally invasive treatment modality for the replacement of a single missing incisor even in cases of congenitally missing teeth that are often associated with hard and soft tissue defects that need to be properly managed to optimize the esthetic outcome. The lack of a retentive form due to the minimally invasive preparation form makes the adhesive bonding procedure for RBFDPs relatively technique-sensitive and might discourage practitioners from offering this treatment modality. A patient with both maxillary lateral incisors congenitally missing was assessed for eligibility for treatment with RBFDPs. Bilateral horizontal ridge defects were present and treated through ridge augmentation to ensure an ovate pontic design and enhance the esthetic outcome. A minimally invasive preparation within enamel was conducted; the restorations were digitally designed and milled out of (3Y-TZP) zirconia ceramic with labial veneering with feldspathic ceramic for enhanced esthetics. An improved design of positioning splints was used for the adhesive bonding procedure to ensure exact, secure, and flawless insertion of the restorations. RBFDPs offer a highly esthetic treatment modality for missing teeth in the anterior area. Tissue defects could be overcome be means of a minor oral surgery, while using improved positioning splints might ensure flawless adhesive bonding and promote the usage of RBFDPs. Hard and soft tissue defects can be remarkably optimized through a minor ridge augmentation. Improved positioning splints allow an easy and secure positioning as well as visual inspection of the seating in end-position and complete removal of resin cement excess. Implementing the concept of insertion splints might promote RBFDPs for anterior tooth replacement as it helps preventing bonding errors.