Patients waiting on implants can also consider this option as a temporary solution before getting implants. It also requires very nominal preparation on its adjacent teeth as the Maryland dental bridge procedure includes re-contouring, which also removes a portion of the enamel of the teeth.
After which a teeth impression is made from conferring to which a temporary bridge is made to keep infection at bay. Lastly, the permanent Maryland Bridge is attached. It can be removed very easily later on in case the patient requires any other form of a dental implant.
Every dental procedure has its advantages and disadvantages, in the same way, the Maryland Bridge Pros and Cons are also inevitable. Some of the Maryland Bridge Pros and Cons are as follows:. Generally, a Maryland Bridge can last in between 5 to 15 years, with the appropriate care and getting regular dental check-ups.
The common lifespan for these bridges remains for over ten years among various individuals. Maryland bridges can cause damage to the teeth that are healthy.
The reason behind this damage may be the presence of cementing metal at the back of teeth. These bridges can also not resist much pressure during chewing unlike the other bridges. The way a Maryland bridge is designed is slightly dissimilar to the way other types of dental bridges are made.
The main reason behind this is that this process requires a very minimal preparation time of the supporting teeth. Firstly, the supporting teeth are prepared after which the dentist makes an impression of the teeth which needs to be replaced. Once the porcelain pontics are prepared, it is then attached to the supporting natural teeth with the help of dental cement or resin.
Frequenlty asked questions. Why is it called Maryland bridge? Adjacent teeth Traditional bridges: Require the entire coverage of the adjacent teeth which is used for supporting the bridge.
Maryland bridges: They take support from a relatively smaller area from the adjacent teeth on the lingual side inner side. Tooth preparation Traditional bridges: More extensive tooth preparation or trimming of the adjacent teeth is required.
Maryland bridges: Very little trimming or preparation is required. Front vs back teeth Traditional bridges: They can replace both front or back missing teeth with good strength and greater support. Maryland bridges: They can replace front teeth with good esthetics but better to avoid for back teeth , where the masticatory forces forces while chewing are considerably high. Number of missing teeth Traditional bridges: Preferred when a long bridge is required to replace more than 1 missing tooth.
Maryland bridges: They are at greater risk of failure if used to replace several missing teeth in a row. The materials commonly used are metal, porcelain, and composites. Indications of Maryland bridge: Replacement of single missing teeth Missing teeth in the anterior or front region where esthetics is the main concern - a fixed type of porcelain Maryland bridge is indicated. When the adjacent teeth have laminates on the facial or outer surface where full tooth preparation is to be avoided.
Good height and sound enamel of the abutment capable of supporting the bridge. A tooth in arch curvature - a fixed movable type of Maryland bridge is recommended. Good moisture control. Healthy oral cavity and good maintenance. Contraindications of Maryland bridge: Several missing teeth in a row. Rear teeth where the forces while swallowing are very high. Crowded teeth, because of the higher chances of dislodgement of the bridge.
Carious abutment - cavities in the abutment causes failure as the cavity progresses over time. Also, it mechanically weakens the tooth structure. Carious abutment should be treated by caries removal and restoration along with a full crown and bridge to replace the missing teeth. Deep closure of mouth - deep bite. Severely proclined front teeth, which are more prone to trauma. Crowding of teeth with little space for tooth replacement.
Parafunctional habits like night grinding or bruxism. Sensitivity to nickel. Need a local dentist? Call our experienced support to help you find an experienced dentist in your local community. The most important advantage is minimal preparation of abutment: conservative preparation. Lesser risk of sensitivity and pulp exposure while preparation.
Margins of the wings are above the gingival gums level which helps in easy removal of the plaque and easier maintenance of hygiene. No anesthesia is required for the procedure. Reduced chair time. Economical : Lower costs as compared to traditional bridges, where three crowns are placed to replace one missing tooth.
Easy and quick to prepare : in comparison to other types of bridges, the process of fabrication of Maryland bridges is simpler and easier. Limited usage: Maryland bridges are only suitable for use in very few clinical situations. Therefore, they are not used very commonly for tooth replacement.
Metallic appearance: Our original teeth are naturally translucent. They show partially the color of the metal wings attached at their back surfaces, and hence, appear slightly darker than the other original teeth. Thus, an undesirable color mismatch can occur. To overcome this problem, frameworks of Maryland bridges are being prepared by using zirconia or other types of high strength ceramics.
Maryland bridges usually don't last as long as traditional bridges. A false tooth with a thin wing of metal bonded to the adjacent teeth. What could go wrong? This post describes a real-life-Maryland-bridge-gone-wrong and how we were able to correct it. When you see enough of these things you quickly see the problems that arise over and over again: darkening of the front teeth from the metal wings, and even more frustrating, debonding of one of the wings without any loosening of the other.
Immediately after insertion of the bridge, the aesthetic drawbacks were obvious- the front teeth looked dark due to the metal wings. She hated it, but her parents had paid for it and it was already cemented into her mouth. Not long ago, this patient returned to report that one of the wings had actually detached from the tooth. Not good, because it was still attached to 3 other teeth and that would have made removing and recementing very difficult.
Incidentally, it is thought to be the movement of the supporting teeth in different directions when chewing that causes loss of bond strength. So what to do?
We sectioned the bridge in the midline to see if we could just remove the bridge on that side and recement it, but still no luck. We were now forced to look at the replacement of the entire Maryland bridge. Although dental implants in the two spots would have been ideal, the root angulations of the adjacent teeth as well as the insufficient volume of bone made that impossible.
After some discussion, we decided that the replacement of the bridge with two separate cantilever all-ceramic bridges was the best option. Our patient wore a cheap-o acrylic partial denture to temporarily replace the missing teeth while she whitened and while the prostheses were being made by the lab. Surprise surprise, she hated it, but luckily it was only needed for a short time. We finally got rid of the denture and bonded the two glass ceramic bridges onto her canine teeth the third ones from the middle.
For the dental nerds: bilateral IPS e. Max bridges replacing lateral incisors, cantilevered off the canines. A final note: this is not a solution that can be used anywhere. Cantilever Maryland bridges have pretty poor survival in all other areas of the mouth except for upper lateral incisors, and it just so happened that not only did this patient have missing lateral incisors, the bite against them was very light.
Being able to minimize the forces against these bridges means that we have a better expectation of long-term success.
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