Maryland Bridge Before Dental Implant

My daughter has a genetically missing lateral incisor. We’ve made plans to get her a dental implant but are having a problem with her temporary restoration. Her dentist placed a Maryland Bridge but is having trouble getting it to stay on. We tried using ceramic wings because we thought that would be more aesthetic. Now we’re wondering if metal wings would be better to keep it on. Will that make her tooth dark? Is there a better solution?

Morgan

Dear Morgan,

In order for a Maryland Bridge to stay in properly, there needs to be some tooth preparation done. Without that, the wings will just fall off, as you are experiencing. In reality, the non-metal wings will stay better than the metal ones. And yes, your concern about the metal showing through is valid.

Looking at the image to the left, you can see that there is a notch placed into the tooth in order to help anchor the bridge there. I will admit to being a little confused as to why your dentist is placing a Maryland bridge for the temporary tooth replacement. Whenever you have to alter the tooth structure, that is no longer a temporary tooth replacement.

Your dentist was correct that a dental implant is the best tooth replacement. He or she is also correct that there needs to be a temporary replacement there until her jaw is fully developed and ready for a permanent restoration. My only concern is the Maryland Bridge.

In a way, it is a good thing that this hasn’t stayed on because it gives you an opportunity to change her replacement option. In your place, I would ask for a refund on the Maryland Bridge and then get her a dental bridge. This is a much better temporary replacement and it will not affect her other teeth at all. You’ll also find it costs significantly less, which is always a bonus when you are raising a teenager.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.