The short answer is that we know a lot more now than we did five years ago about the outcomes of these types of restoration. Clinicians who provide these routinely over the years have modified the designs from their first inception in the late 70’s early 80s’. For example where previously it was thought that a perforated wing would aid retention better outcomes are achieved with utilising non-perforated wings to increase surface area for adhesion-this evolved and coincided with improvements in etched related bonding. Somewhat counter-intuitively a lack of preparation presented with higher success-this is likely to be associated with optimal enamel bonding that is more likely to result. Other aspects include the improved success rates with cantilevered designs as opposed to fixed-fixed designs.
Due to their predictability, the lack of biological cost and efficiency in provision they have become a suitable and realistic alternative to implants especially where patients present with systemic issues, a lack of bone volume or feel tentative when considering a invasive surgical procedure.
Below is an infographic summarising what many consider a landmark study in the provision of these restorations by Paul King and colleagues from Bristol. AA