Clinical Efficacy of Anterior Ceramic Materials in Resin-Bonded Fixed Dental Prostheses with Different Bridge Designs—A Systematic Review and Meta-Analysis

Background: Resin-bonded fixed dental prostheses (RBFDPs) have become an increasingly popular minimally invasive solution for replacing missing anterior teeth. However, their long-term success is influenced by factors such as bridge design and material selection. Methods: This systematic review and meta-analysis aimed to assess the impact of different bridge designs on the clinical performance and failure risks of anterior ceramic RBFDPs. A comprehensive search of electronic databases was conducted to identify clinical studies published in English up to January 2025. Nine studies, including randomized controlled trials, cohort studies, and clinical trials, met the inclusion criteria. Results: The analysis revealed that single-retainer RBFDPs demonstrated lower failure rates than two-retainer models (RR: 0.36, 95% CI: 0.17–0.75). Among failure types, fractures were significantly less common in cantilever designs compared to two-retainer designs (RR: 0.25, 95% CI: 0.09–0.73), while no significant differences were observed in debonding rates (OR: 0.40, 95% CI: 0.015–1.10). Conclusions: In terms of material selection, all-ceramic RBFDPs in cantilever designs exhibited significantly lower failure rates (RR: 0.12, 95% CI: 0.03–0.43), whereas metal-ceramic RBFDPs showed no significant difference in failure rates based on bridge design (RR: 0.56, 95% CI: 0.21–1.53). These findings suggest that all-ceramic cantilever RBFDPs may offer superior long-term outcomes, highlighting the importance of precise preparation and cementation protocols for clinical success.