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Controversy exists surrounding resin-bonded bridges (RBBs), particularly with regards to abutment preparation. Should the abutments be prepared? If the abutments are prepared what design should be adopted? If there is to be no preparation, will there be space for the restoration? Many factors need consideration when planning for this treatment. This article aims to explore the effect of abutment preparation. In this regard, a literature review was conducted to present the latest available evidence.
CPD/Clinical Relevance: Minimal intervention is key in modern dentistry, so clinicians must be able to make confident decisions in the provision of minimally invasive treatments like the RBB and be aware of the latest evidence.
Article
Two schools of thought exist within this field; one which advocates abutment tooth preparation and one which believes that preparation is unnecessary.
In 1997, Shillingburg stated that ‘no cements compatible with living tooth structure and the biologic environment of the oral cavity possess adequate adhesion properties to hold a restoration in place solely through adhesion’.1 It stands to reason, therefore, that some degree of tooth preparation is necessary to afford the resin-bonded bridge (RBB) retention form and resistance. But how accurate is Shillingburg's statement and is there any evidence for it?
Conversely, Ibbetson2 stated that an RBB cemented onto unprepared enamel will enjoy a satisfactory longevity without having to compromise the integrity of the abutment. This ideology relies upon the Dahl principle, whereby space for the restoration is gained through axial tooth movement in place of tooth reduction.3,4
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