In this article I am going to explain more details about a special type of a dental bridge – the Maryland bridge. Basically a dental bridge is a form of denture that replaces missing teeth. The surrounding teeth are used as an anchor and provide stability of the whole structure. In between we have the false teeth or so called the pontic.
The Maryland bridge is a commonly used type of a dental bridge. Most of the dentists prefer to use it as a temporary bridge while doing their implant work. What makes the Maryland bridge so popular among the implantologists? It has plenty of advantages. It needs very few adjustments and it is very easy to place. It is very conservative method of replacing missing teeth which means you don’t have to remove any healthy tooth structure. You just have to roughen the surface of the surrounding teeth, etch the surface, bond and place composite resin cement to bond it ot the teeth. A placement of a Maryland bridge takes around 4-5 min.
The Maryland bridge consists of two wings made of cast metal. The wings are like a framework and have little gaps where the cement flows in. The flowable composite cement bonds to the etched enamel surface so no burs are needed. The only thing a dentist may do before placing a Maryland bridge is to polish the enamel surface of the tooth. That can be done by blasting it with aluminium oxide powder or using dental polishers. The procedure eliminates the risk of experiencing tooth sensitivity.
The false tooth or the pontic is just between the two wings. It can be made of acrilyc or porcelain. The upside of the ceramic Maryland bridges is that they are more esthetic. However if the gums start to recede (which oftenly happens after a tooth extraction) you may end up with a gap between the gum and the pontic. Ceramic material cannot be added to the pontic. When you have an acrylic Maryland bridge more acrylic may be added to the false tooth in order to close the gap. This is especially important while working in the esthetic zone – upper incisors, canines and premolars.
The Mariland bridge can be used as a definitive treatment as it is much cheaper that an implant. Replacing lateral incisors with a Maryland bridge works just perfectly. However it cannot be used in the molar region for a long time. The occlusal forces will make the bridge debond from the surrounding teeth. Most of the dentists use this resin retained bridge as a temporary before placing the abutment and the crown over their implants. The patients do not leave the dental office with a gap and nobody can see that they have missing teeth. The Maryland bridge is easy to remove in order to evaluate the healing of the gum below and to uncover the placed implants. After the debonding of the Maryland bridge it can be bonded again following the same procedure: roughening the enamel surface, etching, bonding and placing the composite cement along with the bridge. Curing with the light cure lamp depends on the type of the composite cement used (usually 10-20 seconds).