Posterior Cantilevered Single-Retainer All-Ceramic Resin-Bonded Fixed Dental Prostheses: A 12-Year Clinical Case and Proposed Clinical Recommendations

Abstract

Objective: To present a clinical case featuring a posterior cantilevered single-retainer all-ceramic resin-bonded fixed dental prosthesis (PC-RBFDP) with 12 years of follow-up. This FDP was used to restore a missing premolar using a single-retainer canine abutment. The aim was also to draw clinical recommendations based on current data and experience.

Methods: To address the present case, the missing premolar was replaced with a stratified 3Y-TZP zirconia PC-RBFDP fabricated from a conventional impression using CAD-CAM technology. The prosthesis was bonded using a resin luting cement containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP), and the patient was reevaluated semi-annually. Insights obtained from this case, along with advancements in scientific understanding based on current data, are further explored.

Results: This clinical case, which occurred 12 years ago, was successful. Building on the insights gained from this case and subsequent ones, modifications to the preparation geometry have been implemented, informed by the in vitro biomechanical findings presented herein. Furthermore, a step-by-step clinical procedure is suggested, drawing from experience with other cases and the current literature on PC-RBFDPs.

Conclusions: With a necessity of caution due to the limited evidence supporting this therapy, this clinical case shows promising results in the use of ceramic RBFDPs in the posterior region, providing an alternative to implants in contraindicated patients. The comprehensive approach shown in the step-by-step clinical case and the manuscript, including indication assessment, selection of bonding materials, ceramic choice, and preparation geometry, utilizes, to the best of our ability, the most current information and technology available. Continued research is needed to further validate this treatment modality.