Single-retainer all-ceramic resin-bonded fixed dental prostheses: Long-term outcomes in the esthetic zone

J Esthet Restor Dent. 2023 Jan;35(1):64-73. doi: 10.1111/jerd.13001. Epub 2022 Dec 29.

Abstract

Objectives: To present an update on the concept of cantilevered single-retainer all-ceramic resin-bonded fixed dental prostheses (RBFDPs) first presented 25 years ago in the Journal of Esthetic Dentistry.

Overview: The initially presented case of the concept was followed clinically over 26 years and is presented along with two additional clinical long-term cases using varying methods to obtain an esthetic and hygienic ovate pontic design. Veneered alumina and zirconia ceramic (3 mol% yttria-tetragonal zirconia polycrystalline ceramic; 3Y-TZP) was used and bonded with a phosphate monomer containing luting resin after 50 μm alumina particle air-abrasion at 0.25 MPa pressure. The restorations replacing incisors did not debond and soft tissues in the pontic area were maintained over 26 years.

Conclusions: Cantilevered single-retainer all-ceramic RBFDPs today made from veneered 3Y-TZP zirconia ceramic can be considered a standard of care for the replacement of single incisors and provide an excellent esthetic outcome with a long-term preservation of soft tissues in the pontic area.

Clinical significance: Bonding nonretentive oxides ceramics such as alumina and zirconia ceramic with phosphate monomer containing luting resins after alumina particle air-abrasion is durable over decades. This proves that bonding to zirconia ceramic is not of any problem when adequate methods are used. Single-retainer zirconia ceramic RBFDPs maintain soft tissues in the edentulous area of single missing incisors and often deem implants unessential for this indication.

Keywords: durable zirconia ceramic bonding; long-term clinical outcome; ovate pontic design; single tooth replacement; single-retainer RBFDPs; soft tissue preservation.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Oxide / chemistry
  • Ceramics / chemistry
  • Dental Bonding*
  • Denture, Partial, Fixed
  • Esthetics, Dental
  • Phosphates / chemistry
  • Resin Cements* / chemistry
  • Zirconium / chemistry

Substances

  • Aluminum Oxide
  • Phosphates
  • Resin Cements
  • single bond
  • Zirconium
  • zirconium oxide