Maryland Bridge

Maryland Bridge

Maryland Bridges

The Maryland bridge is a method used to replace a missing  tooth, without having to prepare the neighboring teeth.

A Maryland bridge consists of a metal framework with a porcelain tooth connected onto the front of the framework. The framework then ends up as a false tooth with one or two metal wings on the side. These metal wings are prepared to have a porous surface so that they can receive a bonding agent and then the wings are bonded to the back sides of the teeth on either side of the missing tooth.

The non-metallic option is zirconia, a material that mimics natural teeth due to its tooth colored appearance. The single retainer cantilever design from Zirconia ceramics has shown very good esthetics and strength.

 

Advantages of a “ Maryland bridge ” 

  •       Minimal tooth structure needs to be removed.
  •       Abutment teeth are not damaged. They are basically left intact.
  •       Because of the conservative nature of the preparaton, the potential for pulpal trauma is  minimized.
  •       Anesthesia is often unnecessary in order to prepare the teeth.
  •       Less periodontal irritation results in comparison with  the conventional bridge

 

  • Problems Associated with a Maryland Bridge

    Though it is valuable, Maryland bridge has some problems in regard to the use of metal and the  longevity of the bridge bonding.

    • It is used only when one tooth is missing
    • Teeth are translucent. The metal backing will cause the teeth to darken slightly, so the result is a slghtely different  color than the other front teeth. To overcome this problem we design the framework to fit at the palatal portion of the tooth.
    • The false tooth is a porcelain fused to metal. This will make it lack the natural translucency and vitality that other teeth have in them. The use of zirconia that mimics the colour of natural teeth resolves this and the above problems.
    • There is a tendency of the  wings to debond, depending on the chewing forces applied on the bridge. Therefore the bridge has to be recemented every few years. The single retainer cantilever design from Zirconia ceramics has shown very good performance concerning this issue.
    • Several studies indicate that anterior bridges tend to have a better performance than posterior bridges.

 

In conclusion:  The Maryland bridge has been  successful and is used in dentistry for more than 30 years. The quality and design of the bridge have been proven successful both as a transitional and permanent prosthesis. It can last more than ten years if one takes relevant care of it and mantains a good hygiene regime.