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Single-wing zirconia resin bonded fixed dental prosthesis (RBFDP) from yesterday's post. This conservative option can now be a long lasting treatment option with the right case selection (94.4% survival rate over 10 years for single-wing vs. 73.9% for double-wing ). The lab process was so fun for this case!
Tx considerations: Adult patient presented with missing lateral incisors who would like a fast fixed solution. Root convergence does not allow implant placement. Low caries risk. Adjacent teeth do not have any restorations or enamel wear. No parafunctional habits, and exhibits anterior guidance in protrusion and excursive movement. Adequate clearance from abutment tooth to the opposing arch.
Tooth preparation: Only in the enamel with a cingulum seating groove and small proximal box. Material: e.max ZirCAD MO (Flexural strength >900Mpa) (Minimum connector size: 12mm^2). Single wing RBFDPs made from pressed lithium disilicate have shown similar survival rate as well, but its mode of failure is often fracture at the connector instead of debonding. Lithium disilicate RBFDPs also require a larger connector size (16mm^2). Cement: Panavia V5 (Enamel was etched with phosphoric acid, and tooth primer applied; bonding surfaces of zirconia were particle abraded with aluminum oxide (1-2bar) and treated with ceramic primer plus). Workflow (swipe-->): (1) Esthetic mock up using bisacryl --> (2) Pontic site development using essix following gingivoplasty --> (3) Teeth preparation/PVS impression --> (4) Prosthesis digitally designed, and milled in zirconia --> (5) Layered using e.max ceram --> (6) Delivery (w/ resin cement system containing MDP under RD isolation).
Kern, Matthias, and Martin Sasse. "Ten-year survival of anterior all-ceramic resin-bonded fixed dental prostheses." Journal of Adhesive Dentistry 13.5 (2011). .
Sasse, Martin, and Matthias Kern. "All-ceramic resin-bonded fixed dental prostheses: treatment planning, clinical procedures, and outcome." Quintessence Int45.4 (2014): 291-297.
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