Resin-bonded Bridges Research Articles

Maxillary lateral incisor agenesis is a common dental anomaly with significant esthetic and functional repercussions. This case report describes a 17-year-old female patient presenting with bilateral agenesis of the maxillary lateral incisors (teeth 12 and 22), managed through orthodontic treatment using the Roth technique with space opening, followed by implant-prosthetic rehabilitation. The treatment outcome demonstrated a significant improvement in esthetics and function. The discussion compares possible therapeutic approaches: space closure versus space opening, and implant-supported versus resin-bonded bridge rehabilitation.

The goal of this study was to determine the survival rate, success rate, and periodontal health quality (PHQ) of glass fiber-reinforced composite (FRC) resin-bonded fixed dental prostheses (RBFDPs) over an observation period of up to 22 years. RBFDPs reinforced with unidirectional glass fiber strands were fabricated directly (n = 16) or indirectly (n = 31; *n = 1 missing data) for 48 adult patients (24 female, 24 male) and used to replace 39 anterior teeth and 9 posterior teeth in the maxilla (n = 33) or mandible (n = 15) using different framework designs: single-retainer (n = 8), double-retainer (n = 33), or multi-retainer (n = 7). Their fate was classified as a success, functional survival, or failure based on observed complications. PHQ was evaluated by measuring PPD, CAL, SBI, and PI around the abutment teeth and unrestored reference teeth (controls). The clinical quality of the restorations was evaluated according to the Fédération Dentaire Internationale (FDI) criteria. Statistical analysis included Kaplan-Meier survival analysis, Wilcoxon tests, Mann-Whitney U tests, and Chi-squared tests. The significance level was set at P 0.05 for all statistical tests. The outcome was 'failure' in 37 cases (52.9%), 'functional survival' (at a mean follow-up of 9 years) in 15 cases (25.7%), and 'success' in 18 cases (25.7%). The median time to first complication was 32.0 months. The most common complications were debonding and fracture. Multi-retainer FRC-RBFDPs had the highest complication rates. Most FRC-RBFDPs were of good clinical quality according to FDI criteria. PHQ scores showed significantly higher clinical attachment level (CAL) (pw = 0.027) around abutments (3.40 ± 1.42/controls: 3.09 ± 1.11) and significantly greater plaque accumulation around abutments (pw = 0.008, 3.28 ± 1.03/controls: 2.83 ± 1.02) and pontics (pw = 0.001, 3.50 ± 0.99/controls: 2.83 ± 1.02) than around control teeth. Pocket probing depth (PPD) values were lower for abutments (2.43 ± 0.49) than for control teeth (2.52 ± 0.55). The opposite was true for sulcus bleeding index (SBI) scores (abutments: 0.64 ± 0.76/controls: 0.42 ± 0.71). There were no significant differences in periodontal health variables between younger and older restorations. In group comparisons, mean and median PPD, CAL, and plaque index (PI) scores for abutment and control teeth were higher in older patients than in younger patients. Based on our survival and complication data, FRC-RBFDPs can be considered short- to medium-term restorations. A 5-year survival rate of approximately 80% can be expected. The most common complications were reparable defects. Thus, repairs can prolong the survival time in many cases. Patient age had a greater effect on PHQ than restoration age. For example, FRC-RBFDPs in older patients were associated with higher levels of plaque accumulation and gingival inflammation around abutments, suggesting that older patients have greater difficulty cleaning the resin-bonded bridge area.

Zirconia Resin-bonded Bridges: An Alternative Approach for Minimally Invasive Dental Prostheses Using the Computer-aided Design/Computer-aided Manufacturing Technology: A Case Report

Resin-bonded bridges offer a simple and conservative approach to tooth replacement. However, the use of this treatment option has been limited in terms of practicality and effectiveness. Therefore, this study aimed to evaluate the attitude and awareness of dentists towards resin-bonded bridges (RBBs) in Benghazi. An online survey was conducted with 200 dentists registered with the Libyan Dental Syndicate. A structured questionnaire, adapted from previous studies, was distributed through Google Forms to gather data on demographics, professional qualifications, attitudes, and awareness of resin-bonded bridges. The data were analyzed using SPSS version 25.0. Out of 300 distributed questionnaires, 200 dentists responded, giving a response rate of 67%. A majority, 83.8% of specialists and 88.1% of general dental practitioners, used RBBs in <10% of their prosthodontics cases. A total of 94.9% of SPs and 67.3% of GPs considered RBBs as a provisional restoration. Additionally, the participants, 98% of SPs and 83.2% of GPs regarded debonding as the biggest disadvantage of RBBs. Focused educational programs and hands-on training in resin-bonded bridges are needed to bridge the gap between theoretical knowledge and clinical application of RBBs. These efforts will empower GPs and SPs in Benghazi, leading to better patient outcomes and expanding restorative treatment options.

Aesthetic outcomes of treatment options for missing maxillary lateral incisors significantly influence patient satisfaction. This study compared aesthetic treatment outcome preferences for canine substitution, resin-bonded bridges and implants among Australian orthodontists, prosthodontists, general dentists and laypeople. A cross-sectional online survey assessed attractiveness ratings and preferences using a ranking system and a Likert scale. One-way and two-way ANOVA examined differences by respondent group and treatment type. Among 547 respondents (orthodontists: 117, prosthodontists: 56, general dentists: 167, laypeople: 207), significant differences were found in aesthetic ratings (p < 0.001). Canine substitution was rated most attractive (mean rank = 1.43), followed by resin-bonded bridges (1.78), while implants (2.81) and no treatment (3.99) were rated lower. Two-way ANOVA showed significant main effects of treatment type and respondent group (p < 0.001), with an interaction effect indicating varied preferences among groups. Canine substitution was the preferred treatment outcome aesthetically, particularly among orthodontists. Resin-bonded bridges were also favoured. These findings highlight the impact of professional background on aesthetic preferences and emphasise the need for patient-centred treatment planning.

Resin-bonded bridges or resin-retained bridges (RRBs) are considered acceptable fixed prostheses for single-unit spaces in the aesthetic zone, often resulting from hypodontia or trauma. They may be used as medium-to long-term treatment options and can precede implant placement for young patients. Provisional tooth replacement before this treatment modality is not always thought to be necessary, but is often seen as appropriate. This article explores the various provisional options for single/multiple tooth space scenarios, their functional and aesthetic considerations, the risks and benefits, alongside their possible impact on the final restoration. CPD/Clinical Relevance: Various techniques available to provisionalize RRBs to aid in RRB case planning are described.

In essence the resin-bonded fixed partial denture, or resin-bonded bridge, is an artificial tooth that is bonded to 1 or 2 abutment teeth. If the resin-bonded bridge is directly made with resin composite intra-orally, then the connector area is the weakest link. The alternative is to produce an indirect resin-bonded bridge in which a metal or ceramic frame spans the space between the abutments. The bridge is bonded to the abutments with composite. The moderate clinical results of the resin-bonded bridge can be associated with a deficiency of the abutment teeth preparation. Therefore, strategic preparation with grooves and rests is of substantial importance for proper support. By doing so, the longevity of the straightforward resin-bonded bridge rivals the performance of other dental provisions. There is a disagreement whether 2-unit resin-bonded bridges perform better than their 3-unit counterparts. Two optimally prepared abutment teeth are still a solid basis for a metal-ceramic resin-bonded bridge. For ceramic resin-bonded bridges, 1 abutment seems to be sufficient.

Resin Bonded Bridges: A Comparative Case Study

Digital workflow for ceramic cantilever resin-bonded bridges: case report

A 19-year-old girl, in a good general health condition, has consulted for aesthetic reasons: replacing her left upper central incisor. Her financial state doesn’t allow her an implant; mixed restoration, but the presence of a bilateral diastema makes the situation difficult as we can’t realize a classic resin bonded bridge, in this case we chose to modify the shape of the resin bonded bridge by using a double loop connector shape that keeps the space between the teeth apparent and so keeps the diastemas.

Ceramic Cantilever Resin-bonded Bridge: An Alternative to the Supra-implant Prosthesis? A Case Report

Resin-bonded bridges (RBBs) are a minimally invasive and aesthetically pleasing treatment modality. However, their frequent failure has posed challenges for both dental professionals and patients. This necessitates the exploration of innovative strategies to enhance the longevity of RBBs. This study aimed to assess the bond strength of a mesh bridge fabricated using computer-aided design and three-dimensional (3D) printing technology in comparison to the traditional aluminum oxide sandblasting method. A total of 48 lower incisors were embedded in acrylic bases according to a standardized computer-generated model to receive 24 metal RBBs. The two groups underwent distinct metal surface treatments: the 3D mesh novel design and sandblasting with aluminum oxide particles sized at 250.00 µm. The bond strength of the bridges was evaluated, and statistical analysis was performed using the independent samples t-test with a significance level set at α = 0.05. The findings revealed a significant difference between the two methods (p < 0.001). The 3D mesh design exhibited a mean bond strength of 387.89 ± 24.15 N, while the sandblasting technique yielded a mean value of 161.46 ± 31.25 N. In summary, the 3D mesh design substantially enhanced the bond strength of RBBs compared to the traditional sandblasting technique.

Fixed partial denture (FPD) prostheses restore esthetics and function by connecting and fixing to adjacent teeth. Conventional FPDs require, for better retention and resistance, extensive preparations. Those preparations include buccal, palatal or lingual coverage, proximal guide planes, chamfers and /or grooves to optimize retention.1–4 The removing of such large amount of tooth structure increases the risk of periodontal complications and pulp exposure.1,3 In 1973, Rochette introduced resin bonded FPDs as a less invasive therapeutic option. He pioneered the use of lingual perforated cast alloy framework with acid etch composite for periodontal splinting of the anterior region.5 However, early Rochette bridges presented high failure rates. Since then, resin bonded FPDs have evolved with different framework materials and designs. Even though metal frameworks are highly resistant, they do have esthetical and mechanical limits such as the greyish appearance of the abutment teeth and dislodgment by the early loss of retention.2–4,7 This led to introducing metal free FPDs, also widely developed thanks to adhesive dentistry. The preparation designs for RBFPDs were strictly limited to the enamel. Studies revealed a survival rate of 86% after 3 years without retentive preparation.6 All Ceramic RBFPDs have been introduced in the early nineties of the last century as a treatment option for missing incisors. Adhesive dentistry has undergone major transformations in current concepts. It has launched new resin bonded FPD designs that allowed to be more conservative such as single unit cantilevered ceramic bridges which become the most commonly used design when replacing lateral incisor especially when implant supported crowns cannot be indicated.8 Placing an implant is not always possible in cases where there is an insufficient bone height or width or for patients with general pathologies that may limit implant indications. That is why in some cases it is compulsory to indicate an FPD. Anterior ceramic RBFPDs showed promising results and high survival rates. They have proved to be viable and reliable alternative.8

Maxillary lateral incisor agenesis (MLIA), treated orthodontically by space opening, requires complimentary aesthetic rehabilitation. Resin-bonded bridges (RBBs) can be equated as interim rehabilitation until skeletal maturity is achieved to place an implant-supported crown or as definitive rehabilitation in case of financial restrictions or implant contraindications. Scientific evidence of the best material must be confirmed in specific clinical situations. Computer-aided design and computer-aided manufacturing (CAD/CAM) materials are promising versatile restorative options. This study aimed to identify a straightforward material to deliver interim or definitive RBBs for nonprepared tooth replacement in MLIA. Single-retainer RBB made from CAD/CAM ceramic blocks (Vita Enamic [ENA], Suprinity [SUP], and zirconia [Y-ZPT]) and a three-dimensional (3D) printed material (acrylonitrile butadiene styrene [ABS]) were evaluated by shear bond strength (SBS) and mode of failure, after adherence to an artificial tooth with RelyX Ultimate used in a three-step adhesive strategy. The load to fracture (N) was recorded, and the mean shear stress (MPa) was calculated with standard deviations (SD) for each group and compared between materials using boxplot graphics. One-way analysis of variance (ANOVA) followed by the Tukey-Kramer post hoc test was used to compare the differences (α = 0.05). A meta-analysis focusing on CAD/CAM materials evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% confidence interval [CI]; Z-value = 1.96). Failure mode was determined by microscopic observation and correlated with the maximum load to fracture of the specimen. The mean ± SD SBS values were ENA (24.24 ± 9.05 MPa) < ABS (24.01 ± 1.94 MPa) < SUP (29.17 ± 4.78 MPa) < Y-ZPT (37.43 ± 12.20 MPa). The failure modes were mainly adhesive for Y-ZPT, cohesive for SUP and ENA, and cohesive with plastic deformation for ABS. Vita Enamic, Suprinity, Y-ZPT zirconia, and 3D-printed ABS RBBs are optional materials for rehabilitating MLIA. The option for each material is conditioned to estimate the time of use and necessity of removal for orthodontic or surgical techniques.

The objective of this study was to identify and characterise various resin-bonded bridge (RBB) articles published in dental journals using bibliometric analysis. The search was performed using the Scopus database to generate publications related to RBB. Data analysis and visualisation were done using Microsoft Excel, Biblioshiny software or VOSviewer. The trend of publication shows an annual growth rate of 7.19 percent within the years 1973–2022. Sixteen articles were cited more than 100 times, with seven highly cited articles focusing on the survival and/or complications of RBB. Matthias,Kern is the most prolific author in RBB research with Journal of Prosthetic Dentistry being the most influential journal. “survival”, “dental bonding” and “zirconia” were identified as core research areas for RBB for the past 10 years. Future research on the incorporation of new technology in prosthesis fabrication to assess the survival and longevity of RBB is expected to increase, with an emphasis on bonding to new materials. This paper presents an overview of scientific production, prominent researchers and countries, emerging keywords and core research areas in RBB research.

Resin-bonded bridges are one of the main options for replacing missing teeth for hypodontia patients. This technique offers several advantages for these patients, who are often young, have unrestored abutment teeth, and have had tooth positions optimised by orthodontic treatment. However, the replacement of missing teeth can be challenging due to tooth positions and anomalies of abutment tooth shape and size.These patients are often young adults at the time of restoration, making the minimally invasive nature and predictable long-term success of resin-bonded bridges advantageous over other treatment methods.This paper in the hypodontia themed issue discusses the importance of case selection and gives practical advice for the design and provision of resin-bonded bridges.

Introduction Patients with hypodontia can be seen by a multidisciplinary team clinic (MDT) for treatment planning at the University Dental Hospital of Manchester (UDHM). The MDT consists of orthodontics, restorative dentistry and oral surgery colleagues.Aims and methods A retrospective case-note analysis was conducted on 558 hypodontia patients seen on Manchester Hypodontia Clinic (MHC) between 2016-2022 to assess service utilisation and treatment planning outcomes.Results The average age of patients attending the MHC was 16 (range 8-50). The distribution of mild, moderate and severe hypodontia in the sample was 28%, 37% and 35%, respectively. Most common treatments proposed were fixed appliances, extractions, implants and resin-bonded bridges. Out of 558 patients seen for consultation on the MHC, 365 (65%) were accepted for treatment. The average number of visits for treatment was 15.5 (range: 1-55). The average number of did not attend/was not brought appointments, patient cancellations and hospital cancellations were 0.8, 1.4 and 1.8, respectively.Conclusion Hypodontia patients referred to UDHM are triaged by consultants in orthodontics or restorative dentistry, and if MDT planning is required, they are booked onto the MHC. There are sufficient patients with complex cases of moderate and severe hypodontia to justify a regular MDT hypodontia clinic.

Most patients seeking treatment for hypodontia will require prosthetic replacement of their missing teeth. This will be in the form of dentures, bridges and implant restorations. As these are created by one or more dental technicians who supports the clinical team, a close working relationship between these colleagues is likely to improve the quality of treatment outcome. This interaction will usually occur towards the end of the patient's treatment process, when definitive restorations are prescribed. However, appropriately trained and experienced dental technicians should be involved throughout the patient's treatment process as an integral part of the multidisciplinary team approach to effectively manage these patients.This paper describes the contribution of dental technicians to patient care with particular focus on communication between the restorative dentistry clinical team and the dental technician to improve the quality of anterior restorations. As missing maxillary lateral incisor teeth are a common presentation for this patient group, further technical detail relating to planning resin-bonded bridges for replacement of these teeth is included.

Longevity of cantilever resin-bonded bridges: a scoping review

The Dahl Concept describes the re-establishment of occlusal contacts after the provision of a planned localised appliance or restoration in supraocclusion. Initially developed to create space for prosthetic rehabilitation of anterior teeth suffering from localised wear, the principle has later been successfully applied to a variety of situations, including the Hall technique and resin-bonded bridges cemented in supraocclusion. Despite high levels of success seen in the relevant literature and widespread adoption in specialist care, the wider profession appears to be far more cautious in its use. This article aims to provide a brief summary of the Dahl Concept and discuss the local and general factors that influence its successful implementation in the hope of promoting its increased adoption by the broader dental profession.