Theriot Family Dental

Maryland Bridge as a Temporary Restoration?

My daughter is 12 years old and we just finished her orthodontics. She has a congenitally missing lateral incisor that we plan on getting a dental implant for when she is older and her jaw is well developed. Our dentist said we needed some temporary tooth replacements there and suggested we use a Maryland  Bridge with non-metal wings so they would blend with her teeth better.  We are having the darndest time trying to keep the thing in. Our dentist has tried two different types of cement. She is considering trying metal wings next. I have a couple of questions about this though. First, will the metal show through making her teeth look darker? 2. Do you think the metal will do any better than the non-metal? We’ve been spending way too much time at the dentist lately and I need to find a real solution so we can get on with our lives.

Amy

Dear Amy,

Maryland Bridge Diagram with wings

Let me start by saying that you picked the best permanent tooth replacement option for your daughter. A dental implant will be like having a healthy, natural tooth in her jaw again. As to the choice of the temporary tooth replacement, that has been a bit of a disaster, hasn’t it? I know you were only going on the recommendation of your dentist. Though I can tell that your dentist is trying, she doesn’t seem to understand how a Maryland Bridge works.

As to whether the metal will show through, yes it will. Her adjacent teeth will look darker.. This is why more and more dentists are moving toward non-metal wings with Maryland Bridges. Your second question is whether the metal wings will bond better than the non-metal. The answer to that is no. In fact, your dentist will probably have more trouble bonding the metal. If the non-metal is easier, why is she still having trouble with it?

Tooth preparation for a Maryland BridgeHer biggest problem is she is not adequately preparing the tooth. If you look at the image to the left you will see that a notch has been cut into the tooth. This is important to help keep the wings in place.

That notch is also why I would not consider a Maryland Bridge a temporary tooth replacement. Whenever you have to alter the structure of a tooth, to me that is not temporary. Once her Maryland Bridge is removed, that notch will still be there. Granted, it can be filled, but why should you pay for additional work for something that was supposed to be temporary.

Instead, I am going to recommend you forgo the whole idea of a Maryland Bridge and just get her a dental flipper. This requires no adjustments to her teeth and is much less expensive.

Who Should Do Her Dental Implant?

When the time comes for her to get her dental implant, I am going to suggest you make sure you go to someone with real expertise. I’m not convinced her current dentist has the post-doctoral training necessary to do this well. It will need to last her many years, so you’ll want the best doc possible.

In your place, I would look for someone who was a fellow with the International Congress of Oral Implantologists. These dentists have proven expertise and will do an excellent job.

This blog is brought to you by Lafayette, LA Dentist Dr. John Theriot.