Do zirconia single-retainer resin-bonded fixed dental prostheses present a viable treatment option for the replacement of missing anterior teeth? A systematic review and meta-analysis

Abstract

Statement of problem: Zirconia has been widely used in restorative dentistry because of its favorable strength and esthetics. However, its polycrystalline structure presents a challenge for resin bonding. Significant research into surface treatments of zirconia to improve bonding has been reported, yet a universally accepted protocol remains elusive.

Purpose: The purpose of this systematic review and meta-analysis was to evaluate the performance of anterior single-retainer zirconia resin-bonded fixed dental prostheses (RBFDPs) and review the bonding protocols used in the published data.

Material and methods: An electronic search of English language literature was conducted in the PubMed and Ovid (MEDLINE) databases. Following the application of inclusion and exclusion criteria, the research was evaluated to assess the quantitative data.

Results: Of the included studies, 1 randomized controlled trial, 3 prospective cohort studies, and 2 retrospective cohort studies reporting on anterior single-retainer zirconia RBFDPs were evaluated. Over a 3- to 10-year period, the success rate of anterior single-retainer zirconia RBFDPs was over 80%. Although there were reports of debonds, this is a minor complication as rebonding is usually possible. Furthermore, catastrophic fractures of the entire prosthesis were rare.

Conclusions: Evidence for the use of single-retainer zirconia RBFDPs as a suitable treatment option for the replacement of anterior missing teeth is considerable. Based on the findings of this systematic review and meta-analysis, a 2-step process comprising micromechanical retention using airborne-particle abrasion and subsequent resin-zirconia adhesion by the application of 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) can be recommended.