Congenitally missing laterals pose esthetic challenges. A problem inherent to traditional Maryland bridges is that the retainers do not allow for incisal translucency, and show-through of metal occurs in the interproximal space if retainers are extended. Another restorative challenge for this type of prosthesis is that the wings of the bridge are limited to the cingulum of the abutment teeth and rely solely on the strength of the cement for retention. With advances in high-strength tooth-colored materials and the development of more translucent zirconia, clinicians can anticipate an improved esthetic outcome with this restoration. Furthermore, enhanced primers containing organophosphate enable predictable longevity. Newer color-stable luting resin also contributes to superior esthetic outcomes by allowing the transmission of light, thus preserving the natural esthetics of the teeth without obstructing the natural tooth substructure. This case report describes the use of zirconia-based resin-bonded fixed dental prostheses (FDP), bonded using a series of products from Bisco Inc. (www.bisco.com) to replace failed metal-bonded FDP for teeth Nos. 7 and 10.
• Historically, replacement of congenitally missing lateral teeth has been done via a cement-retained, metal-based FDP, referred to as a Maryland bridge.
• Improvements in high-strength tooth-colored materials and primers along with the development of translucent zirconia have enabled improved esthetics.
• Color-stable luting resin allows transmission of light to preserve natural-looking restorations.
Shannon D. Roberts, DDS
Assistant Clinical Professor
Department of Comprehensive Dentistry
University of Texas Health Science Center at San Antonio School of Dentistry
San Antonio, Texas
Nasser Barghi, DDS
Professor, Department of Comprehensive Dentistry
University of Texas Health Science Center at San Antonio School of Dentistry
San Antonio, Texas
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