No-Prep Zirconia Cantilever Resin-Bonded Fixed Dental Prostheses: A Noninvasive, Simple Approach to Replacing a Single Missing Tooth

Objectives

To introduce no-prep zirconia cantilever resin-bonded fixed dental prostheses (Z-RBFDPs) as a noninvasive and simple approach to replacing individual anterior and posterior teeth.

Clinical Considerations

Sixteen no-prep Z-RBFDPs were placed in 11 patients with a single missing tooth (15 lateral incisors, 1 canine, and 1 premolar); nine exhibited bruxism, and four used a nightguard. Bridges were bonded using a rubber dam and Panavia V5 resin cement after grit-blasting zirconia, etching the enamel (n = 13) or Vita Enamic palatal veneer (n = 3), and applying an MDP-based primer. The survival rate was 100% after a mean follow-up of 3.0 ± 2.6 years (range: 1 month–9.5 years). An Z-RBFDP on an upper canine showed debonding after 2 years, and the bonding procedure was successfully repeated. Patient-reported outcomes were positive. Key considerations included restoration design, material selection, bonding procedures, and multidisciplinary soft tissue management. An innovative 3D-printed resin guide was introduced to ensure accurate bridge positioning during the bonding procedure, and the simple orthodontic extrusion technique was used to manage the limited occlusal space.

Conclusion

This case series provides proof of principle for no-prep Z-RBFDPs, demonstrating high survival and success rates, even in the presence of known risk factors such as bruxism and unfavorable occlusal relationships.

Clinical Significance

No-prep Z-RBFDPs offer a promising, noninvasive, cost-effective, and straightforward alternative to dental implants for single-tooth replacement. They effectively avoid related complications such as infraposition and peri-implantitis. Further research is required to validate these preliminary findings, particularly for posterior applications. Treatment choices should increasingly align with the patient's preference for noninvasive procedures that prioritize tooth tissue preservation and avoid surgical interventions, as demonstrated in this case series.