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For several years, all-ceramic resin-bonded bridges (RBBs) have been considered an aesthetic treatment option for the replacement of missing teeth in the anterior region. With continued developments in technology, various different ceramic materials have been used to fabricate all-ceramic RBBs including zirconia, glass-reinforced, alumina-based ceramics, and lithium disilicate glass ceramics. The aim of this article is to provide an overview of all-ceramic RBBs, the advantages and disadvantages associated with these prostheses, as well as to demonstrate their application in replacing missing anterior teeth.
CPD/Clinical Relevance: To present the current literature and clinical application of all-ceramic resin-bonded bridges for replacing missing anterior teeth.
Article
Resin-bonded/resin-retained bridges (RBBs/RRBs) are a well-recognized minimally invasive fixed prosthetic tooth replacement option. They have been in use since the 1970s, being briefly described by Rochette1 for their use in periodontal splinting before Howe and Denehy2 described in detail the use of perforated cast retainers for replacing missing teeth as a temporary restoration. However, these initial restorations demonstrated poor longevity.
In the intervening 40 years, with advancements in adhesive cements, improved understanding of retention methods, design of the prosthesis and developments in the materials used for RBB construction, it is now regarded as a predictable long-term tooth replacement option.3
There are a number of treatment options available when replacing missing teeth. These include resin-bonded bridgework, conventional fixed bridgework, conventional dentures and implant-retained prostheses.
RBBs have been shown to have a reasonable survival rate4,5,6,7 with systematic reviews estimating the five-year survival rate for RBBs at 87.7%,8 conventional bridges at just over 90% (dependent on the design)9 and 94.5% reported for implant-retained single crowns.10 Despite this slightly lower survival rate, RBBs are a simple, minimally invasive tooth replacement option for replacing a short span or single tooth and can be used as both an interim or definitive tooth replacement option.11 RBBs are also less invasive with reduced biological consequence in comparison to other tooth replacement options, such as conventional bridgework.12 They have reduced costs,13 and have been shown to have high patient satisfaction.14
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