Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

March 28, 2007

Maryland bridge won’t stay in.

Filed under: Dental bridges — Tags: , — mesasmiles @ 7:38 pm

Dr. Hall
Due to a failed root canal, I had tooth #12 removed and a bone graft in preparation for a dental implant. My dentist and the oral surgeon agreed that a Maryland bridge would be a good temporary plan for me cosmetically. My dentist placed it post surgery and it fell out after only 12-13 hours. He again placed it and it fell out in less than 2 days. He has taken another impression for another bridge but I have to wonder if the new Maryland bridge will be any more successful than the original one. I have eaten only soft foods post surgery 5 days ago. I am at my wits end and would like any recommendations you may offer.
– Betty from New Jersey

One thing about Maryland bridges is that they are bonded in, not cemented, so they require a knowledge of bonding technology that may be beyond the training of some general dentists. So here I have a list of possibilities why your Maryland Bridge didn’t stay in. I don’t know why it fell out. Things go wrong in every dental office from time to time. But here are some possible reasons:

1. It was placed too soon after the surgery when there was still oozing and bleeding from the surgery that contaminated the bond. And now that a little more time has passed, it will be easier.

2. The bleeding and oozing from the surgery had stopped, but the dentist still wasn’t able to completely control contamination from saliva. He should be able to get that done trying one more time.

3. The dentist didn’t make an adequate preparation for the Maryland Bridge. (There have to be certain grooves and divots placed in the adjacent teeth to hold a Maryland Bridge well.)

4. It was the oral surgeon’s idea, and your general dentist really doesn’t know how to do a Maryland Bridge, but didn’t want to appear to have a lack of knowledge.

As far as the reason why your dentist couldn’t re-insert it and get it to stay, that’s easier. Once a Maryland Bridge falls out, it can’t be re-bonded without a special treatment of the metal. The metal surface of the wings of the Maryland Bridge are etched, and if it falls out, those wings should be re-etched in order for it to stay in. If your dentist has a type of a mini-sand-blaster called a micro-etcher, he can re-etch it himself. Otherwise, he has to send it back to the laboratory and they can do it.

If the Maryland Bridge doesn’t work this third time, maybe you should have him do a dental flipper for you. Read more about dental bridges in the main section of
Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

1 Comment »

  1. Is the metal used in a Maryland bridge
    – Kevin

    Your question brings up an interesting issue, and I think it is deserving of its own blog post, which I will write. Here is a link to it:
    Is the Metal in a Maryland Bridge MRI Safe?
    – Dr. Hall

    Comment by Kevin Shaw — October 26, 2016 @ 9:13 am

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