Attal J-P, Tirlet G, LeCorre M, Boitelle P, Dursun E, Benoit A, Valtaud L, Caussin E, François P
Jean-Pierre Attal, DDS, PhD, Department of Biomaterials, University of Paris-Cité, Paris, France.
Gil Tirlet, DDS, PhD, Private Practice, Paris, France.
Oper Dent. 2025 May 1;50(3):235-244. doi: 10.2341/24-116-S.
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.
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.
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.
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.
介绍一例采用后悬臂单固位全瓷树脂粘结固定义齿（PC-RBFDP）修复且随访12年的临床病例。该固定义齿用于使用单固位尖牙基牙修复一颗缺失的前磨牙。目的还在于根据当前数据和经验得出临床建议。
针对本病例，采用CAD-CAM技术通过传统印模制作分层3Y-TZP氧化锆PC-RBFDP来替代缺失的前磨牙。使用含10-甲基丙烯酰氧基癸基二氢磷酸酯（10-MDP）的树脂粘结剂粘结修复体，并且每半年对患者进行一次重新评估。进一步探讨从该病例中获得的见解以及基于当前数据在科学认识方面取得的进展。
这个12年前发生的临床病例取得了成功。基于从该病例及后续病例中获得的见解，结合本文给出的体外生物力学研究结果，对预备体外形进行了改进。此外，借鉴其他病例的经验和当前关于PC-RBFDP的文献，提出了一个逐步的临床操作流程。
鉴于支持该治疗方法的证据有限，需要谨慎对待，但该临床病例表明在后部区域使用陶瓷RBFDP有良好的效果，为禁忌植入的患者提供了一种替代方案。分步临床病例及文稿中展示的综合方法，包括适应证评估、粘结材料选择、陶瓷材料选择和预备体外形设计，尽我们所能利用了现有的最新信息和技术。需要持续研究以进一步验证这种治疗方式。
