An investigation into aspects of resin-retained bridge design on aesthetics and oral health-related outcomes: a randomised controlled trial.

Aims To assess whether removing the incisal metal edge of an anterior resin-retained bridge (RRB) improves aesthetics without compromising clinical performance.Methods A two-phase study was conducted. Phase 1 involved a single-centre, parallel-group, randomised controlled trial (1:1 allocation) of 40 dental patients requiring anterior tooth replacement who received either the original or an adjusted RRB design. Participants completed an oral health-related quality of life (OHRQoL) questionnaire before and after treatment. Phase 2 assessed aesthetic preferences among three groups - hypodontia patients, the public, and dental care professionals - who rated photographs of both RRB designs using a five-point Likert scale.Results In Phase 1, both groups showed significant improvements in OHRQoL following treatment (p <0.001), with no difference between RRB designs. No bridge failures occurred over a 50-month follow-up. In Phase 2, pooled analysis revealed a preference (p <0.001) for the adjusted design. No statistical differences were observed between participant groups.Conclusions Removing the incisal metal improves aesthetic outcomes of anterior RRBs without affecting short-term survival. Both designs improved OHRQoL. The aesthetic questionnaire demonstrated potential as a valid tool for comparing fixed prosthetic outcomes.