A new design for all-ceramic inlay-retained fixed partial dentures: A report of 2 cases

In a previous clinical study, all-ceramic resin-bonded 3-unit inlay-retained fixed partial dentures (IRFPDs) had a significantly worse outcome in the posterior region than did crown-retained 3-unit FPDs made from the same material. Debonding or fractures were causes of failure. To improve the clinical outcome of IRFPDs, a new framework design was developed: (1) The inlay retainers were made out of CAD/CAM-manufactured zirconia ceramic to improve fracture resistance, and additional veneering of the inlays was omitted. (2) The inlay retainers were completed with a shallow occlusal inlay (1-mm minimum thickness) and an oral retainer wing (0.6-mm minimum thickness). The wings were designed to reduce stress on the inlay retainer caused by torsion forces when the FPD is loaded nonaxially and to increase the enamel adhesive surface area. The pontic was circumferentially veneered with feldspathic porcelain. The clinical and laboratory procedures of this new treatment modality are described, and 2 exemplary clinical cases are presented. This new preparation and framework design might improve the clinical outcome of all-ceramic resin-bonded IRFPDs. However, adequate evidence of long-term safety and efficacy is required before this new design can be recommended for general clinical practice. Keywords: adhesive, all-ceramic restoration, CAD/CAM, fixed partial dentures, inlay-retained, preparation, zirconia