In the UK, Resin-bonded Bridges (RBBs) are used regularly only by a minority of dentists, and their longevity is much lower than in published clinical trials. Objectives: To establish the reasons for this discrepancy by examining practitioner behaviour and beliefs.

Methods: Using the payment database for dental services under the UK's National Health Service, we drew a nationally representative sample of 600 dentists stratified by frequency of usage of RBBs. A pre-validated postal questionnaire defined the detail of practising behaviour and beliefs of the sample. Results: The response rate was 62%. After weighting, only 43% of dentists involved in crown and bridge provision had placed more than 3 RBBs in the previous year and 24% had placed none. The rate of recements was higher than the rate of first time cementation suggesting low longevity. There was a gulf between what dentists said they would do and what they actually did; for example 59% of dentists might consider replacing a lower premolars with a RBB, but only 17% had ever done so. There were differences between regular and infrequent users. Regular users associated premolar replacements with success; low users with failure (p<0.001). Other factors associated with failure (periodontal condition, replacements of canines and molars and the replacement of teeth in the presence of certain occlusal problems) were seen as significantly less of a problem by the regular users (p<0.05). Only around half used specific components of tooth preparation such as guide planes (43%) and grooves (56%), despite evidence from trials supporting this practice.

Conclusions: With regard to the use of RBBs, there are important differences between the practising behaviour and beliefs of general dentists', and best practice based on evidence. If success rates are to be improved these need to be addressed.

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