Technique tips: planning for failure

Whilst we all like to think our restorative treatment will last indefinitely, the fact of the matter is that everything will fail, given time. The forward thinking practitioner would be wise to take this into consideration when treatment planning.

A 60-year-old businessman wanted a fixed solution for missing UL45. He dismissed both removable and implant solutions. A bridge was acceptable and thoughts around the bridge design were considered. A fixed/fixed design with full coverage restorations at UL3 and UL6 was considered, however, the UL3 was an unrestored, sound tooth and it was felt that this was overly destructive.

The UL6 had previously been root-filled and so a full coverage restoration was indicated. A minimally invasive, resin-retained retainer at UL3 was considered as the mesial retainer. However, given that in my experience at the time, adhesive retainers were probably more likely to fail than fixed retainers, something which was subsequently confirmed by research by Burke and Lucarotti,¹ thought was needed as to how this might affect the long-term survival of the bridge if there was a debond of the adhesive retainer.