Abstract
Purpose: This case report describes the restoration of a missing lower second premolar using a direct resin-bonded fixed partial denture (RBFPD), employing the composite resin injection technique with a digital workflow and a transparent silicone index. While conventional direct composite RBFPD can be technique-sensitive, this approach simplifies and standardizes the process, making it less dependent on the operator’s experience.
Methods: A 50-year-old male patient sought restoration of a missing lower second premolar, preferring to avoid cutting intact teeth or surgical interventions such as dental implants. Thus, a direct composite RBFPD was chosen. The restoration was digitally designed, and a transparent silicone index was fabricated from a 3D-printed dental model, which featured mesial and distal, narrow bucco-lingual extensions to prevent overflow of the composite resin. After the adjacent abutment teeth were bonded with a two-step self-etching adhesive, a highly filled universal-shade flowable composite resin was injected through the opening of the occlusal surface of the silicone index.
Results: The procedure proved to be straightforward, with the success of treatment being less dependent on clinical technique sensitivity. In the laboratory, the need for conventional free-hand wax-up with paraffin wax was eliminated in favor of digital wax-up. The design resulted in less overflow of the flowable composite resin in the cervical area, enhancing cleanability with interdental brushes. A functional and esthetic replacement of the missing premolar was achieved without tooth preparation.
Conclusion: This technique provides a minimally invasive and cost-effective solution with predictable clinical outcomes, establishing it as a potential definitive restorative option.
