Minimally invasive preparation and design of a cantilevered, all-ceramic, resin-bonded, fixed partial denture in the esthetic zone: a case report and descriptive review.

UNLABELLED: Resin-bonded, fixed partial dentures have the potential to offer a minimally invasive, fixed-prosthetic approach to tooth replacement in patients who may not be candidates for implant therapy. However, traditional preparation protocols often recommend extensive preparation designs on two abutment teeth, thereby potentially compromising the long-term health of the adjacent abutments and often resulting in unilateral debonding of one of the retainers in the long term. In light of advances in high-strength ceramic systems capable of being reliably bonded to tooth structure and offering improved esthetic outcomes, as well as clinical and case-series research demonstrating improved survivability of cantilevered resin-bonded fixed partial dentures, new preparation designs and methodologies can be advocated. The following case report demonstrates the clinical application of sonoabrasion, coupled with a dental operating microscope, to minimally prepare a single abutment for a cantilevered, all-ceramic resin-bonded fixed partial denture. Relevant historic and contemporary literature regarding double versus single-retainer resin-bonded fixed partial dentures are reviewed, as well as clinical conditions that are most favorable for such restorations to have an optimal long-term prognosis. CLINICAL SIGNIFICANCE: If appropriate clinical conditions exist, a cantilevered, all-ceramic, resin-bonded, fixed partial denture may be the most conservative means of tooth replacement in a patient who is not a candidate for an endosseous implant.

Making multiple predictable single-unit provisional restorations using an indirect technique.

This article describes a method to fabricate single provisional restorations for multiple preparations using an indirect technique. Provisional restorations need to mimic the definitive restoration as closely as clinically possible. When multiple adjacent provisional restorations are fabricated, the ability to make each separately, with its own path of insertion and contour, aids in providing a predictable final result for the patient. Individual provisional restorations will also allow the patient to maintain better hygiene.