Resin bonded (Maryland) bridge

When one tooth is missing and the neighbouring teeth are healthy, it seems a pity to reshape them for a conventional bridge (an artificial tooth held by crowns on the two reshaped neighbours), and implants may not be possible right now. A resin bonded bridge helps in this situation. At UKRMED it is done as part of tooth restoration.

Photo: Richard Avery, Wikimedia Commons, CC BY-SA 3.0

What is a Maryland bridge

It is a restoration in which an artificial tooth is attached to the neighbouring teeth with adhesive that bonds strongly to enamel. The neighbouring teeth are not crowned, or are prepared only minimally on the inner side. That is why the method is considered conservative: it preserves the natural teeth.

Who it suits

• one missing tooth, most often a Maryland bridge front tooth replacement;
• healthy neighbouring teeth or teeth with small fillings;
• a bite that does not overload the area;
• a quick solution, for example while preparing for implants, or for a teenager whose jaw is still growing.

It is not suitable for people who grind their teeth, with loose neighbouring teeth, large fillings on them or several missing teeth in a row.

Compared with other options

• Implants - the most durable solution that leaves neighbouring teeth untouched, but needs surgery, time and a bigger budget.
• A conventional bridge on crowns - reliable, but the neighbouring teeth must be reshaped.
• Maryland bridge dental treatment - conservative and quick, but more sensitive to load.

How long it lasts

A systematic review found that 91.4% of resin-bonded bridges were still in function after 5 years and 82.9% after 10 years. The most common complications were debonding (the bridge coming unstuck) and minor chipping, which can often be fixed by re-bonding.

How it is done

1. Examination. The dentist assesses the neighbouring teeth, bite and gums. Any decay is treated first.
2. Preparation. The surfaces of the neighbouring teeth are cleaned and, if needed, minimally prepared on the inner side.
3. Making and bonding. The artificial tooth is bonded to the neighbours and the bite is checked.
4. Polishing and instructions.

Care

• brush twice a day and clean under the artificial tooth with an interdental brush or water flosser (a device that cleans with a jet of water);
• do not bite hard food with the front teeth in the bridge area;
• have a check-up and professional cleaning every 6 months.

Prices

Sources

1. Thoma D. S., Sailer I., Ioannidis A. et al. A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years. Clin Oral Implants Res, 2017. https://doi.org/10.1111/clr.13007