What is a Maryland Bridge?
One method which can be used to replace a missing tooth is the Maryland Dental Bridge. A common belief is that this bridge technique was created by dentists at the University of Maryland. Alternative information suggests that the bridge was actually invented by Dr. Stewart R Halbauer, a dentist in Atlanta. The technique was then discovered and made popular at the University of Maryland. Dr. Gus Livaditis and Dr. Van Thompson were the dentists at the University of Maryland who made the Maryland Bridge a popular treatment option. Based on the website for Dr. Livaditis, however, he never claims to have invented the Maryland Bridge method, but rather, he states that he and Dr. Thompson shared the responsibility of developing the bridge.
A Maryland bridge is used when only one tooth is missing and includes metal framework with a porcelain tooth which is baked onto the front area of the framework. The framework then provides a false tooth with two metal wings on each side. These metal wings are precisely prepared with a porous surface, which helps ensure that they are able to properly receive the bonding agent. During placement, the wings are bonded to the back surface of the teeth adjacent to the missing tooth.
Benefits of the Maryland Bridge include:
- Minimal removal of healthy tooth structure
- No damage to the abutment teeth, which are left intact
- Conservative and minimal preparation required
- Risk for pulpal trauma is minimal
- Anesthesia is not typically required
- Periodontal irritation is uncommon
Unfortunately, there are two main esthetic issues associated with a Maryland bridge. Both issues are related to the use of the metal on the bridge. The first issue is that natural teeth have a translucent appearance. As a result, the metal backing which is secured to the back side of the front teeth, causes the teeth to be slightly darker in appearance. In addition, they will no longer match the color of the other teeth in the front of the mouth. When the dentist fails to take this darkening effect into account, which often occurs, the false tooth is slightly lighter in appearance compared to the darkened teeth on either side.
The second issue associated with the Maryland Bridge is that the false tooth which is used is created with porcelain fused to metal. It fails to have the natural translucency and vitality of the other natural teeth. The most esthetic and natural-looking false teeth are those which are made using tooth-colored materials.
Below are some of the alternative options which provide a similar solution to the Maryland Bridge.
- Through the development of tougher new ceramics, the more aesthetic version of the Maryland Bridge can be created using zirconia.
- The Encore Bridge is another alternative. This type of bridge is made completely from tooth-colored materials, meaning it is more esthetic and has a more natural appearance.
- The ovate pontic technique is another alternative option to the Maryland Bridge. This technique gives the appearance that the false tooth is growing out of the gum.
While the Maryland Bridge has some disadvantages, the treatment has proven to be successful and has been used for more than 20 years. The treatment has been successful both as a transitional and permanent replacement solution which can last for more than 10 years when it is properly cared for.