Question:
I saw the thread above about bridge alternatives, but I wanted to ask
specifically about the 'Maryland Bridge', and how it compares to the
traditional crown bridge.
Most dentists seem to want to use traditional type crown bridges, and thats
what my dentist is planning. But I dont know whether its because they are
better in that they last longer, or because the maryland type bridges are
newer, and therefore not as many dentists are skilled in its application.
I certainly dont want my dentist to apply something hes not familiar with .
And Im sure he wouldnt do it. But is it worth changing dentists just to
find one familiar with this technology, if Im happy with my dentist in most
other areas?
Answer:
Maryland bridges have been around a long time. I would not want one.
Compared to today's alternatives in dentistry, they have their place and so
does a 386 computer. You will be happier in the long run with a traditional
bridge or an implant to replace # 13.
Modified Maryland Bridge is better....... Maryland Bridges seem to fall off too often!
They are only bonded, not drilled into the tooth ... modification means drilling a lock and bonding the bridge right INTO the tooth!
Wait a second! I've never heard of a "Maryland Bridge." The bridge I just
got is simply glued on to teeth that have been drilled into anchors. What
kind of bridge do I have? I know that it is porcelain over metal...
For many years, dentists had to reduce healthy teeth as abutments for fixed bridges. Now, with the Maryland Bridge, an
ultra-conservative treatment option is available that enables the dental practitioner to splint or replace missing teeth
esthetically, with an absolute minimum of supragingival tooth modification. Combining a microfilled-composite resin cemented to acid
etched enamel and an electolytically acid etched or silicoated cast metal framework, the Maryland Bridge improves the bond strength
of the restoration three-fold over earlier perforated resin-bonded retainers.
Current second-generation designs and tooth preparations, coupled with improvements in cementing resins which rely on adhesive
rather than an etched metal system, have provided even more exciting and reliable restoration possibilities. Adhesive cementation of
the alloy to the tooth structure allows the casting to be supported by abutment teeth. Bonding also prevents displacement back along
the path of insertion. Because displacement of the casting in all directions other than along the path of insertion is prevented by
alloy engaging tooth structure, the framework design limits the stresses placed on the luting agent and bond, dramatically
increasing the longevity of the restoration.
Ultra Conservative Preparation
With the Maryland Bridge, fixed partial dentures, periodontal splints and a variety of other conservative restorations can be placed
with a minimum of tooth modification. Abutment teeth are basically left intact - one unit is not weakened in the process of
replacing another. Modifications are restricted to rest preparations and recontouring of the enamel is only required in severely
undercut cases. All tooth preparations are supragingival, making modifications kinder to the periodontal tissues and impressions
easier to obtain. By avoiding preparations involving dentin, sensitivity is virtually eliminated either from the preparation or
subsequent cementation procedure. Most importantly, as the Maryland Bridge requires little or no removal of tooth structure, the
treatment is often reversible.
