Resin Bonded Bridges (RBBs) are a minimally invasive and aesthetically pleasing solution for replacing missing teeth—especially when implant placement isn’t an option. This blog post explores the types, survival rates, materials, clinical considerations, and common complications associated with RBBs.
What is a Resin Bonded Bridge?
According to the Glossary of Prosthodontic Terms (9th Edition), a Resin Bonded Bridge is a fixed partial denture that is luted primarily to enamel surfaces that have been etched to allow for micromechanical retention of the resin-based luting agent. In simpler terms, it’s a conservative bridge bonded to the back of existing teeth using adhesive techniques—requiring minimal tooth preparation.
Evolution of RBBs: From Rochette to Maryland
The concept began with the Rochette Bridge (1973), which relied on perforated metal retainers and a wrap-around design to achieve retention. A significant advancement came with the Maryland Bridge (1982), which introduced electrolytic etching to enhance micromechanical retention and reduce plaque accumulation. These improvements laid the foundation for the modern RBBs used today.
Survival and Success Rates
Clinical studies have shown high survival rates for RBBs, particularly with proper case selection and technique. One 5-year study reported a survival rate of 87.7%, while more recent data showed 91.4% survival with a 15% rate of de-bonding and 4.1% minor chipping. Notably, zirconia frameworks and single-wing designs demonstrated the highest survival outcomes.
Longer-term studies also highlight the success of RBBs. A 9.4-year review showed a 90% survival rate, although posterior bridges had a slightly higher failure rate—especially when using nickel-chromium alloy frameworks. A 10-year study of zirconia RBBs found an impressive 98.2% survival rate and 92% success rate.
Framework Materials: Pros & Cons
Various materials can be used in RBB frameworks, including:
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Base metal alloys (Nickel-Chromium)
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Zirconia
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Lithium Disilicate
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Fibre-Reinforced Composites
Advantages of RBBs include minimal invasiveness, excellent aesthetics, quick placement, and affordability. They are especially suitable for single-tooth replacements, short-span bridges, and young patients. However, bonding failures and technique sensitivity mean that strict case selection is crucial to long-term success.
Ideal Indications for RBBs
RBBs are ideal when the following conditions are met:
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The abutment teeth have sufficient enamel and surface area.
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The edentulous space is relatively small.
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The patient has favorable occlusion and no severe parafunctional habits.
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There’s minimal misalignment or spacing concerns.
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The patient is young or unable to undergo implant surgery.
Design features are equally important. Retainers must meet minimum thickness requirements (0.7 mm for metal, 0.8 mm for zirconia, and 1.0–1.2 mm for lithium disilicate), with full coverage and minimal occlusal contact. A single retainer wing is preferred to reduce stress on the restoration.
Technique Matters: Clinical Considerations
Successful RBB placement demands attention to several clinical factors:
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Accurate shade matching to avoid grey shadows from metal wings.
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Ideal emergence profile of the pontic.
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Moisture control during cementation.
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Careful occlusal adjustment to avoid placing excess force on the pontic.
Proper surface treatment, correct seating, and following the manufacturer’s cementation protocol are essential steps to minimize failure.
Single-Wing vs. Two-Wing RBBs
Recent studies show that single-wing RBBs, especially when used to replace a maxillary incisor, have superior outcomes. All single-wing bridges survived without complications, while only 50% of two-wing RBBs survived, and just 10% remained complication-free.
This supports the trend toward cantilever RBBs, especially in anterior regions where aesthetics and function align better with this design.
Common Causes of Failure
Failures in RBBs often stem from:
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Moisture contamination at the time of bonding.
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Inadequate abutment selection or insufficient enamel.
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Incorrect retainer thickness or connector rigidity.
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Poor design that cannot withstand occlusal forces.
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Failure to follow bonding protocols or cement instructions.
When failures occur, rebonding may be possible if the cause is identified and corrected. Otherwise, a redesigned RBB or alternative treatment may be necessary.
💬 Final Thoughts
Resin Bonded Bridges represent a conservative and cost-effective alternative to implants and traditional bridgework, especially for younger patients or those seeking minimally invasive solutions. With proper case selection, design, and technique, RBBs can provide long-term function and aesthetics—often exceeding patient expectations.
