What is Maryland Bridge?
A Maryland Bridge is used to replace missing teeth/teeth, especially in cases of front teeth.
It is commonly used in place of central or lateral incenders. These bridges have false teeth and wings extending on one or both sides, sticking to the inner aspect of the side teeth.
It is one of several available restoration methods that are considered minimally invasive and conservative of dental tissues. The crown is made of porcelain attached to metal or ceramic and the feather extensions are metal.
Why is it called the Maryland Bridge?
There is an interesting story behind this name. It is not named after the state of Maryland, nor was it actually invented anywhere in the state of Maryland. The technology was probably invented by Ohio dentist Dr.Stewart R.Halbauer. The University of Maryland later popularized this technique, and therefore, became known as Maryland Bridge.
Who can get the Maryland Bridge?
The Maryland Bridge is ideal for patients who are looking for a reliable and aesthetic solution to replacing their missing front teeth. However, not all patients with missing teeth are eligible to receive the Maryland bridge. These bridges are offered only to individuals who do not have cavities on the supporting teeth and have excellent oral hygiene.
Indications of Maryland Bridge:
Replacement of single missing teeth.
Losing teeth in the anterior or frontal area where aesthetics are of main concern – a certain type of porcelain Maryland bridge is indicated.
When adjacent teeth are laminated on the face or external surface, where complete tooth preparation is to be avoided.
Good elevation and sound enamel of the sanctuary capable of supporting the bridge.
Teeth in arch curvature – A fixed movable type of Maryland bridge is recommended.
Good moisture control.
Healthy oral cavity and good maintenance.
Maryland Bridges Contraindications:
Multiple missing teeth in a row.
Teeth where force is very high during swallowing.
Crowded teeth due to the greater likelihood of dislocation of the bridge.
Carious abutment – Cavities in the abutment cause failure as the cavity moves over time. In addition, it mechanically weakens the structure of teeth. Careful treatment should be treated with caries removal and restoration with complete crowns and bridges to replace missing teeth.
Deep closing of mouth – deep bite.
Severely front teeth, which are more prone to trauma.
A multitude of teeth with very little room for tooth replacement.
Parafunctional habits like night grinding or bruxism.
Sensitivity to nickel.
How are they prepared?
The method of building bridges in Maryland differs slightly from other types of dental bridges. This is because there is a minimal requirement for the preparation of supportive natural teeth. However, in some cases, a slight depression on the inner surface of the teeth may be required to increase the retention of the bridge structure. After the necessary dental preparation, your dentist will make the impression of the prepared teeth, which will be sent to the dental laboratory. Once prepared Maryland is regained, it is attached to the teeth using dental cement.
Benefits:
The most important benefit is the minimum preparation of abutment: conservative preparation.
When preparing sensitivity and low risk of pulp exposure.
The edges of the wings are on top of the gingival layer, which facilitates easy removal of the blade and easy maintenance of health preservation.
The procedure required no anesthesia.
Reduced chair time.
Economic: Less cost than conventional bridges, where three crowns have been set up to replace a lost tooth.
Easy and fast to prepare: Compared to other types of bridges, the process of making the fabrication of Maryland bridges is simple and easy.
Disadvantages:
Bridges in Maryland have two aesthetic boundaries due to the use of a metal structure for support and attachment.
Limited Use: Maryland’s bridges are only suitable for use in very few clinical situations. Therefore, they are not commonly used for tooth replacement.
Presence of metal: Our original teeth are naturally translucent. They partly show the color of the metal wings on their posterior surfaces, and therefore, appear slightly darker than other parent teeth. Thus, an undesirable color mismatch may occur. To overcome this problem, Maryland’s bridges are being designed using zirconia or other types of high-strength ceramics.
The longevity of the bridge is comparatively much smaller than other treatment options.
If space is difficult to improve then it cannot be kept.
Poor alignment of teeth is associated with a high risk of failure.
Aesthetics compiled in posteriors where metal is used for high strength.
Complications of Maryland Bridges:
The most important benefit – saving teeth – is also the most important defect of the Maryland bridges. Since they are not as strongly attached as traditional dental bridges, they may loosen or fall out.
These are the most common problems of Maryland bridges:
debonding
Porcelain Fracture
Loss of adjacent tooth structure due to corrosion
Frame fracture
Nominal rotation of contribution
Periodontitis in abutment and nearby area.
Frequently asked questions:
How long does a Maryland bridge last?
If properly maintained, this bridge lasts for an average of 5 years.
What is the success rate of the bridge?
The five-year survival rate of the Maryland bridge is about 80% and the ten-year survival rate is about 65%.
Can Maryland Bridges Be Removed?
Yes, if any care or sensitivity is seen, they can be removed. This may indicate underlying caries of the aborted tooth structure.
Can it be obtained?
Yes, it can be re-cemented. If a replacement is done after a long period, there might be changes in tooth positions like a tilting of the abutments in the space of missing teeth. So if your bridge doesn’t fill right, visit your dentist as soon as possible.
Can it be attached to the crown?
It can only be attached to the inverted three fourth crown, where the inner or lingual or palatal surface is spared. It can also be placed specifically on teeth with luminaires that are placed in the front teeth for aesthetic purposes.
Can I get braces if I have a Maryland bridge?
The placement of a brace in orthodontic treatment changes the position of the teeth significantly. If the Maryland bridge is present in the mouth during treatment, they may impede the movement of teeth or change the direction of forces on the teeth, causing unwanted teeth to rotate. Heavy force may dislike the bridge.
Therefore it is better to keep it after the orthodontic treatment is completed.
Can I go for an MRI if I have a Maryland bridge?
Yes, you can. Typically, metals disrupt magnetic fields in MRIs. But in these bridges, the amount of metal is very less.
My bridge feels loose, what should I do?
Loose bridges can occur for many reasons, for example, due to caries, adhesive loss, etc. Visit your dentist to find out the underlying cause. If caries is present, they should be treated. If the adhesive is washed off, the bridge can be obtained.
My Maryland Bridge keeps descending, what should I do?
If it stops, simply place it securely with cotton wrapped around it and visit your dentist for an oral examination and recommendation. Even if the bridge is loose enough with too much mobility, it is better to remove it with your hands to prevent accidental swallowing or complete dislocation during swallowing or speaking that may cause trauma to the oral tissues.
Can this gum cause recession?
Proper cleaning and brushing do not cause a recession and improves the chances of success. Gum deceleration is directly proportional to the amount of bone loss, poor bone quality leads to gingival recession. Therefore it cannot be said that gum recession is purely due to the bridge, but many factors may be responsible, including local (oral health and hygiene), as well as systemic factors (diabetes control, blood pressure, bone health, nutritional deficiency)
My bridge feels loose, what should I do?
Loose bridges can occur for many reasons, for example, due to caries, adhesive loss, etc. Visit your dentist to find out the underlying cause. If caries is present, they should be treated. If the adhesive is washed off, the bridge can be obtained.
My Maryland Bridge keeps descending, what should I do?
If it stops, simply place it securely with cotton wrapped around it and visit your dentist for an oral examination and recommendation. Even if the bridge is loose enough with too much mobility, it is better to remove it with your hands to prevent accidental swallowing or complete dislocation during swallowing or speaking that may cause trauma to the oral tissues.
Can this gum cause recession?
Proper cleaning and brushing do not cause a recession and improves the chances of success. Gum deceleration is directly proportional to the amount of bone loss, poor bone quality leads to gingival recession. Therefore it cannot be said that gum recession is purely due to the bridge, but many factors may be responsible, including local (oral health and hygiene), as well as systemic factors (diabetes control, blood pressure, bone health, nutritional deficiency)
The Maryland bridge is one of the most affordable ways to replace a missing tooth. It consists of three units: two metal wings and a retainer, and a middle unit, the pontic, which is a porcelain covered portion of the bridge. A Maryland bridge is cheaper than a conventional one, but the disadvantage is that they can't last as long. A traditional bridge requires more tooth trimming, but it is a permanent solution.
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