Contouring an abutment tooth to aid placement of a resin-bonded bridge

Resin-bonded bridges (RBBs) have been used for the restoration of edentulous regions since the 1970s,¹ with Howe and Denehy being the first to describe the use of a non-preparation adhesive bridge bonded to acid-etched enamel using composite.² RBBs are minimally invasive fixed prostheses that reduce the endodontic risk to abutment teeth compared to more traditional fixed–cantilever and fixed–fixed bridge designs. Placement of RBBs still enables the use of alternative restorative treatment options later on (ie an implant-supported prosthesis). Several factors affect the survival rates of RBBs.³ Survival rates at 5 and 10 years have been reported as 83.6% and 64.9%, respectively.³

The following clinical case demonstrates a useful technique for the provision of RBBs. A patient attended the practice complaining of an unretentive denture that had replaced his upper left central incisor (UL1) (Figure 1). The patient wanted to consider his treatment options for this space, preferably with a fixed prosthesis. The UL1 had been lost due to previous trauma, and his denture was an immediate replacement prosthesis.