The Pioneer Bridge: A Long-Term, Non-Invasive, Esthetic Composite Bonded Bridge for the Replacement of Anterior Teeth

Objectives: The purpose of this study was to evaluate the retentive strength of the Pioneer Resin Bonded Bridge design with no abutment teeth preparations in comparison to the standard Maryland Bridge design. Materials and Methods: Sample Pioneer and Maryland Bridges were fabricated and tested with an Instron machine to evaluate the amount of Pound Force units necessary to cause bridge dislodgement. The Pioneer Bridges were fabricated with a zirconia framework and a porcelain fused to zirconia pontic. Then, Pioneer Bridges were locked to the teeth with micro hybrid composite while the Maryland bridges were cemented with Panavia. Results: The Pioneer Bridges showed 4.0-fold higher retentive strength as compared to the Maryland Bridges tested in this study. Conclusion: This study provides evidence indicating that Pioneer Bridges may improve the current treatment for adolescent patients with congenitally missing lateral incisors for whom implants are not a viable option due to incomplete skeletal growth as well a lower cost alternative for adult patients missing an anterior tooth who cannot afford an implant. Clinical Implications: Esthetics are enhanced with Pioneer Bridges as compared to the Maryland Bridge, given the translucency of the former as compared to the metallic finish of the latter. Additionally, the Pioneer Bridge does not require that the adjacent incisors be damaged for anchoring purposes as is the case with the Maryland Bridge. Also, the Pioneer Bridge expands the age for which a bridge may be employed to adolescents, given that it is not permanently fixed and therefore can be removed with subsequent skeletal growth and replaced with a larger version of the same or an implant upon reaching adulthood. Finally, the cost of a Pioneer Bridge is expected to be significantly lower due to reduced clinician time owing to a lack of tooth preparation