Many dentists have problems with Maryland bridges, resulting in a short lifespan for the bridge. They seem really simple to place—grind the adjacent teeth a little to make space for the metal framework, and then just bond it on. But it’s not quite that simple. There should be certain grooves placed in the preparation to resist the forces that will occur. Otherwise it is very easy to dislodge a Maryland bridge.
And you have the added complication of having porcelain crowns on the adjacent teeth. The ideal is to bond the metal wings of the Maryland bridge to enamel. That gives the strongest bond. Bonding the bridge to porcelain is inherently weaker, even if it’s done right. And very few dentists know how to bond to porcelain.
Then there is the additional complication of having to prepare the teeth with the porcelain crowns so that they have the proper grooves, with retention and resistance form that will help keep the bridge from coming loose. Placing proper grooves could cause the groove preparations to go through the porcelain entirely and reach the underlying metal. Now, instead of bonding to porcelain, the dentist needs to bond to metal, which is more difficult still.
So yes, it can be done. But it’s a high-risk, difficult procedure.
The ideal would be if the dentist would anticipate this possibility back when the original implants were placed. Knowing there is one natural tooth left between the implants, the dentist should be anticipating that at some point in the future the patient could lose that tooth. Then the implants for the missing teeth should be placed so that the abutments end up parallel and then use a screw-retained crown. When the tooth in between is lost, the dentist would simply unscrew the adjacent crowns and replace them with a bridge.
Another solution would be to place a third implant in the missing space, assuming there is enough space in the bone to accommodate a third implant.
Do you have a comment? We’d love to hear from you. Enter your comment below.
Click here to ask Dr. Hall a question of your own.
I am having a Maryland Bridge put in tomorrow. I keep forgetting to ask my dentist a question about it. He said it would have a lifespan of about 10 years. What happens after that 10 years? It is fixed. Does it loosen after that period of time? If it reaches it’s life span, then what happens? Thank you so much for any information that you can provide to me. I’m hoping that I’ve made the right choice, but have already been fitted and the bridge made, so there’s no turning back now.
– Theresa from New York
It’s confusing to people when dentists put a lifespan on dental work. The lifespan will vary so much from patient to patient, it’s hard to really say how long it will last. And it’s not entirely a question of something “wearing out,” it’s more a question of how long it will be until something goes wrong with it.
A tire has a pretty definable lifespan – the rubber wears away on the road at a certain rate, and with average driving conditions you can predict pretty closely how long it will be before the tread wears away and you need a new tire. Dental work is different. I like to compare it to a bookcase. If you have no children in the house and you just put books on it, it doesn’t get any water stains, and you use a wood polish on it periodically, a nice wooden bookcase may last 40 or 50 years and still look pretty good. But if you’re a young family with children and they are putting their drinks on it and their toys and maybe some really heavy things, it’s going to get scratched and stained and maybe in five years it will look pretty bad and be ready for replacement. That’s more like the way dental work is rather than like a tire.
A Maryland bridge is susceptible to loosening, but it depends on the stresses present in your mouth. If you have a stressful bite that tends to flex your teeth, a 10-year lifespan may be optimistic. If you don’t, it could last much longer than that. You could also get decay around the attachments, but that is going to depend a lot on your eating habits, particularly how often you snack. And then the other factor in the lifespan is the rate of staining of your natural teeth. The false tooth in a Maryland bridge is made out of porcelain, which doesn’t absorb stain like your natural teeth do. If you consume a lot of highly pigmented foods like certain berries, coffee, tea, etc., and you don’t do any bleaching of your teeth, the color mismatch could become bothersome, if this is a tooth that shows in your smile, after ten years or so.
I hope this is helpful.
(Note: What I say here about the lifespan of the Maryland bridge would apply also somewhat to the lifespan of an Encore bridge, though I would expect less lifespan out of an Encore bridge. The technique is similar – the Encore bridge is just made out of tooth-colored materials which are more flexible and thus more susceptible to de-bonding.)
|We thank our advertisers who help fund this site.|