Treatment of extended anterior crown fractures using Type IIIA bonded porcelain restorations

Novel-design bonded porcelain restorations, the so-called Type IIIA BPRs, represent a reliable and effective procedure when restoring large parts of the coronal volume and length in the anterior dentition. While traditional treatment approaches involve the removal of large amounts of sound tooth substance (with adverse effects on the pulp, gingivae and crown biomechanics, as well as serious financial consequences), the use of adhesive technology instead can provide maximum preservation of tissues and limited costs. Considerable advantages, such as the economical and noninvasive treatment of crown-fractured teeth, are inherent to Type IIIA bonded porcelain restorations, reducing the need for preprosthetic interventions (e.g., root canal therapy and crown-lengthening) and the use of intraradicular posts. This article, illustrated with cases with up to eight and 10 years' follow-up, sets the scientific foundations of this concept, as well as important considerations about function, strength, tooth preparation, laboratory technique, and bonding optimization.