AbstractBackgroundDifferent treatment options exist for replacement of an anterior tooth, and as implant‐supported single crowns (ISSC) and resin‐bonded fixed dental prosthesis (RBFDPs) both are widespread treatment options, it is of clinical relevance to know which treatment modality can be considered superior.PurposeThe purpose of this comparative study was to evaluate the 3‐ and 5‐year survival and failure rate of tooth‐supported resin‐bonded fixed dental prosthesis compared to implant‐supported single crowns. The null hypothesis was that there was no significant difference in survival rate, occurrence of complications or patient‐reported outcome between RBFDPs and ISSCs.Materials and MethodsA total of 45 resin‐bonded FDPs were inserted in 27 young patients (test group) with tooth agenesis in the anterior part of the maxilla or mandible and a control group of 28 patients also with tooth agenesis in the anterior region but treated with 40 implant‐supported single crowns were included in this study. All patients and treatments were followed with a baseline and a 3‐ or 5‐year examination. All patients had to fill out an Oral Health Impact Profile (OHIP‐49) questionnaire at baseline and at the 3‐ or 5‐year examination. The restorations were evaluated according to the Copenhagen Index Score (CIS).ResultsFor the RBFDP (test) group there was an 82% survival rate and 18% failure rate, that is, four RBFDPs were not in situ after 3 years and four RBFDPs were not in situ after 5 years. Correspondingly, the ISSC showed a survival rate of 98% and a failure rate of 2%, that is, only one failure (ceramic fracture) after 3 and none after 5 years. Of the 82% RBFDPs in situ, there were no complications in 78% of the cases, whereas 22% had complications after 3 (4 complications) and 5 years (4 complications). There were 92% of the ISSCs without any complications and 8% (ie, 3 ISSCs) with complications after 3 or 5 years. In general, there was a significant reduction in the OHIP‐49 scores, for example, an improved oral health quality of life for both treatment options.ConclusionThe results of this study indicate that ISSCs have lower complication and failure rates than RBFDPs. In general, the OHIP‐scores were significantly reduced regardless of whether RBFDPs or ISSC were used.