Philippe Boitelle

Abstract

 In Europe, the loss of a single molar or premolar is one of the most common clinical situations in adults. Traditionally, implant-supported crowns have been the gold standard fixed solution, but they remain costly, invasive, and prone to long-term complications such as peri-implantitis, bone resorption, and, more rarely, implant fractures. These challenges are particularly significant in elderly, dependent, or polymedicated patients.

Posterior Cantilevered Single-Retainer All-Ceramic Resin-Bonded Fixed Dental Prostheses (PC-RBFDPs) have recently emerged as a minimally invasive, more affordable, and reversible alternative. By requiring only minimal enamel preparation, they preserve both bone and periodontal tissues, avoid surgical intervention, and align with a philosophy of responsible, minimally invasive dentistry. Clinical series over the past decade report survival rates above 90% at five years, but the literature still shows discrepancies regarding wing design, choice of materials (translucent zirconia, disilicate, hybrid composites), and adhesive protocols. Large-scale randomized multicenter trials and cost-effectiveness analyses are still lacking.

Our collaborative research program, led by Inserm UMR 1333 – Oral Health, Université de Paris, and the Fixed Prosthodontics Research Group, Université de Genève, focuses on three main challenges: biomechanical design of retentive wings, pre-clinical and clinical validation of protocols, and educational transfer to practitioners. This lecture will present our progress in mapping the relationship between design, biomechanical constraints, and clinical performance of PC-RBFDPs. The aim is to provide decision-making matrices (wing geometry, materials, adhesion protocols), reduce current variability in practice, and develop finite element models correlated with multicenter clinical observations—setting a reference for other minimally invasive adhesive prostheses.