Background: In particular, for adolescents who need to have their lost anterior teeth restored, tooth replacement is essential for function, appearance, and overall quality of life. Resin-bonded fixed partial dentures (RBFPDs) offer a conservative option, yet there is ongoing discussion on the need for tooth preparation. Methods: A single maxillary incisor was lost in twenty-four subjects (16 males and 8 females) with ages ranging from 12 to 18 years old that were part of a randomised controlled trial. Two groups were assigned to the participants: Group I received dental preparation, and Group II received no dental preparation to receive unilateral zirconia RBFDP. Over 12 months, the Visual Analogue Scale (VAS) including its impact on the patient's speech, esthetics, and thermal sensitivity and Papillary Bleeding Index (PBI) were used to measure survival, and patient satisfaction. Results: No statistically significant differences were found in retention and survival rates between the two groups (p = 0.705). Both groups exhibited high patient satisfaction, with VAS scores showing no significant differences at any follow-up point (p > .05). The PBI indicated variations in periodontal health over time, notably in Group II, but no significant differences were observed between groups at 12 months (p = 0.355). Conclusion: This study indicates that regardless of tooth preparation, RBFPDs can be used successfully in adolescents with a single maxillary incisor missing.