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Reverse anterior maryland bonded (rambo) bridge for replacing a tooth with extended pontic space: a case report Nirmal Kurian Kevin George Varghese Samiksha Wadhwa George Abraham Vinaya Susan Varghese Dental Update 2025 52:6, 429-432.
Authors
NirmalKurian
BDS, MDS, Associate Professor, Department of Prosthodontics and Crown and Bridge, Christian Dental College, Ludhiana, Punjab, India
Single tooth loss in the aesthetic zone owing to trauma is a challenging yet common clinical situation. Loss of adequate bony support, additional requirements for bone grafts or unwillingness to undergo dental implant treatments means treatment options are restricted to the conventional, fixed dental prosthesis with the adjacent teeth used as abutments. An extended pontic area owing to a pre-existing midline diastema contradicts the use of a conventional, minimally invasive resin-bonded fixed dental prosthesis that bonds to the palatal surface of abutment teeth. This technique highlights a novel reverse anterior Maryland bonded (RAMBo) bridge concept that prepares the labial surface of abutment teeth only, with the fabrication of a three-unit, all-ceramic, partial coverage dental prosthesis used in the replacement of a single missing anterior tooth. The RAMBo treatment described here uses adhesive bonding with contemporary veneers and a pontic to replace a missing tooth in an anterior aesthetic zone.
CPD/Clinical Relevance: The RAMBo technique offers a minimally invasive and aesthetically favourable solution for single anterior tooth replacement in cases with extended pontic areas.
Article
Tooth loss is associated with aesthetic and functional challenges, especially when a maxillary or mandibular anterior tooth is lost. The prevalence of tooth loss due to traumatic dental injuries has been reported to be 15.2% in permanent dentition.1
Several treatment options exist for replacing missing teeth, including removable partial dentures, conventional fixed dental prostheses and implant therapy. For a long time, complete coverage crowns have provided a predictable and durable choice to replace missing teeth.
However, with the recent advances in adhesive dentistry and the popularity of partial coverage veneers, full-coverage crowns that require a substantial reduction of tooth structure are often less acceptable to dentists and patients. Contemporary conservative restorative techniques rely on ultra-thin partial coverage porcelain laminate veneers and adhesive bonding protocols.2
The resin-bonded fixed dental prosthesis (RBFDP) is a conservative option, with success rates comparable to conventional options, and is a relatively minimally invasive approach.
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