When patients go to the dentist, what they often hear is that they want fixed teeth, that they need three fillings for one missing tooth, that they need to grind down both front and back teeth, or that they need dental implants. Actually, this is not entirely true. This article introduces a fiber-reinforced resin bonded bridge technique. First, let’s explain what a bonded bridge is. It is a restorative technique that does not require extensive grinding of the patient’s healthy teeth and fixes the restoration directly to the patient’s teeth by means of bonding. It is clinically acceptable to patients because it causes little damage to the healthy teeth at both ends of the missing tooth and does not even require tooth grinding. However, in China, in the past, its long-term effect was questioned and its clinical application was rare, even as a temporary restoration method. In recent years, with the rapid development of oral bonding technology, this restorative technique has received renewed attention. Recent studies have shown that the 10-year success rate of adhesive bridges has reached 90%, and therefore, adhesive bridges can be considered as a permanent restoration. Typically, a bonded bridge consists of two parts: the bridge and the metal wing (Figure 1.) In 1973 Rochette used a bonded bridge design with metal bracket material and a metal wing retainer with multiple holes in the adjacent teeth to increase the strength and retention of the bonded bridge. On the basis of this metal wing and metal bridge structure, the structure of the wing and the retention method were continuously improved, which led to the derivation of different types of adhesive bridges, such as Maryland bridge, Virginia bridge and adhesive surface cast mesh adhesive bridge. However, due to the unsatisfactory aesthetic performance (Figure 1), they are not widely used. The fiber reinforced resin bonded bridge is a technique to increase the strength of resin bonded bridge by replacing the traditional metal material with glass fiber. The mechanic process of fiber-reinforced resin bonded bridge is shown in Figure 2, and it can be seen that the aesthetic aspect is greatly improved compared with the traditional metal bonded bridge. Fig. 1 Traditional metal bonded bridge, without grinding healthy teeth, consists of two parts: the bridge body and the metal wings, which are practical but have poor aesthetic properties. Fig. 2 Mechanic processing of a fiber-reinforced resin bonded bridge with glass fiber bundles embedded inside the composite resin Fiber-reinforced resin bonded bridges have been commonly used in dental clinics abroad, especially in cases of single missing lower anterior teeth. Figure 3 shows a before and after photo of a single missing lower anterior tooth restored with a fiber-reinforced bridge, the same case as in Figure 2. Fig. 3 Before and after restoration of a single missing lower anterior tooth with a fiber-reinforced resin-bonded bridge, with arrows showing the restored missing tooth The advantages can be summarized as follows. First, compared to traditional fixed bridge restorations, resin-bonded bridges do not require the removal of a large amount of tooth tissue, and the tooth preparation is generally confined to the enamel layer, protecting the teeth at both ends of the missing area from damage. Even if it loosens, the abutment teeth are still protected by enamel and can be re-bonded or considered again for fixed bridge restoration, leaving one more chance for restoration. Secondly, from the economic point of view, one tooth is missing as long as one filling is needed, while three fillings are needed for one missing tooth according to the tooth preparation design of the traditional fixed bridge. Thirdly, from the material science point of view, the fiber-reinforced resin bonded bridge has good biocompatibility, no undesirable metal ion leakage affecting health, and no black line on the gum margin. Compared with metal and ceramic materials, the mechanical properties of resin and fiber materials are close to the teeth, and the occlusal force is not easily concentrated in the restorations and dental tissues, reducing the possibility of bonded bridges falling off. Fourth, the clinical operation time is short and reduces patient pain. Only a small amount of regrinding of the abutment teeth is required at the first visit to take the model. Compared with traditional fixed bridges, the dental preparation is less difficult and the preparation time is greatly reduced. It is particularly suitable for restoring lower anterior teeth and can also act as a periodontal splint in cases of periodontal disease. It also has the advantage that the gingival margin of the cementum is designed above the gingiva, which is less irritating to the periodontal tissue. Its shortcomings include limited restoration of adjacent malocclusions, high requirements for bonding materials as well as bonding techniques, and generally used for restoration of missing anterior teeth, not suitable for posterior teeth with high occlusal forces. In 2000, the International Dental Federation (FDI) proposed Minimal Intervention Dentistry, which means that oral treatment should protect the patient’s own dental tissue as much as possible. With the continuous development of oral bonding technology, bonded bridges have been recognized as a fixed prosthetic denture with less tooth wear and aesthetic stability. The correct selection of indications and standardized bonding techniques are the key to the success of fiber-reinforced resin bonded bridges. Summary