Dental question - Maryland Bridge.

Dental question - Maryland Bridge.

Author
Discussion

Huntsman

Original Poster:

8,225 posts

257 months

Sunday 9th January 2022
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I have a Maryland Bridge, front top tooth. Its 30 years old.

It did have 2 wings on the back to be glued onto the teeth either side. About 15 years ago after a spate of it falling out and being re-glued, I changed Dentist, he said the two wings were the problem as the teeth move independently, so he chopped off one wing and glued it in, it stayed in place for 15 years.

Last year my son knocked it out, its now come out 3 times, current dentist says the problem is because its only got one wing! She also says its bent, this means the glue is thicker, which contributes to failure.

So which Dentist is right? One wing or two?

I know folk will say an implant is the answer, but they can FRO, you would need to shoot me with a tranquiliser dart at long range! Not happening.

Mr Pointy

11,865 posts

166 months

Sunday 9th January 2022
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Huntsman said:
I know folk will say an implant is the answer, but they can FRO, you would need to shoot me with a tranquiliser dart at long range! Not happening.
I know this isn't answering your question, but why wouldn't you consider an implant?

PurplePangolin

3,230 posts

40 months

Sunday 9th January 2022
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This will be due to your occlusion or bite and will also be due to the age of your bridge ( and possibly the condition of the tissues holding your natural tooth which is in turn holding the bridge)

There should be no reason why you cannot simply replace with a new Maryland bridge that fits better.

Whether you have a Maryland or an implant retained crown - it is important to carefully check the “bite” in all positions of your jaw.

Sometimes implants are pushed when a simple bridge is as effective and that’s before you get in to site “bone” suitability and cost.


Matt Harper

6,771 posts

208 months

Sunday 9th January 2022
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I am currently 3 weeks post-surgery from a significant (whole mouth all-on-four) implant procedure.

If your reluctance to consider an implant option was the same as mine (fear of the barbarity of the process), my concerns were far outweighed by the results and the speed of my initial recovery.

Happy to share my story if anyone is interested.

Piersman2

6,640 posts

206 months

Sunday 9th January 2022
quotequote all
Matt Harper said:
I am currently 3 weeks post-surgery from a significant (whole mouth all-on-four) implant procedure.

If your reluctance to consider an implant option was the same as mine (fear of the barbarity of the process), my concerns were far outweighed by the results and the speed of my initial recovery.

Happy to share my story if anyone is interested.
Yes please... and cost?

Mikebentley

6,719 posts

147 months

Sunday 9th January 2022
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I had my 35 yr old crowns replaced ( 2 front teeth) with an implant and bridge. I consider myself quite resilient generally and said to the wife I wouldn’t need time off work. Jeez it did knock me about and does take a while when done properly but well worth it.

fourfoldroot

601 posts

162 months

Sunday 9th January 2022
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In my experience two winged marylands eventually debond on one of the wings. I always made them with one. You were fortunate to get thirty years out of it in both incarnations. Once they cease to fit, they are doomed. Then it’s time for planB . Wether that is implant or conventional cantilever bridge.

Matt Harper

6,771 posts

208 months

Sunday 9th January 2022
quotequote all
Piersman2 said:
Matt Harper said:
I am currently 3 weeks post-surgery from a significant (whole mouth all-on-four) implant procedure.

If your reluctance to consider an implant option was the same as mine (fear of the barbarity of the process), my concerns were far outweighed by the results and the speed of my initial recovery.

Happy to share my story if anyone is interested.
Yes please... and cost?
I don't want to hijack Hunstman's thread, so I'll do it separately. However, unless there is a clinical reason why an implant is not appropriate, I would urge the OP to at least consider it.

Huntsman

Original Poster:

8,225 posts

257 months

Sunday 9th January 2022
quotequote all
Matt Harper said:
I don't want to hijack Hunstman's thread, so I'll do it separately. However, unless there is a clinical reason why an implant is not appropriate, I would urge the OP to at least consider it.
Fill your boots.

Huntsman

Original Poster:

8,225 posts

257 months

Monday 10th January 2022
quotequote all
fourfoldroot said:
In my experience two winged marylands eventually debond on one of the wings. I always made them with one. You were fortunate to get thirty years out of it in both incarnations. Once they cease to fit, they are doomed. Then it’s time for planB . Wether that is implant or conventional cantilever bridge.
Thank you.

What is a cantilever bridge?

omniflow

2,877 posts

158 months

Monday 10th January 2022
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Huntsman said:
Thank you.

What is a cantilever bridge?
I'm not a dentist, but my understanding is that a cantilever bridge involves butchering the teeth either side of the missing tooth and effectively crowning them with a 3 piece crown, which then bridges the gap.

DO NOT DO THIS - have an implant instead. You'll only be needing one implant. If you have a cantilever bridge you could end up needing 3 implants.

Mr Pointy

11,865 posts

166 months

Monday 10th January 2022
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omniflow said:
Huntsman said:
What is a cantilever bridge?
I'm not a dentist, but my understanding is that a cantilever bridge involves butchering the teeth either side of the missing tooth and effectively crowning them with a 3 piece crown, which then bridges the gap.

DO NOT DO THIS - have an implant instead. You'll only be needing one implant. If you have a cantilever bridge you could end up needing 3 implants.
Blah Blah need to make the link work
http://icaredental.com.my/our-treatments/dental-br...

fourfoldroot

601 posts

162 months

Monday 10th January 2022
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A cantilever bridge involves usually just butchering one tooth next to the gap. It is a final year favourite exam question to write an essay discussing the treatment options for the replacement of a single missing tooth. I merely suggested two courses of replacement but many others are possible. If funds allow, then an implant is treatment of choice if acceptable and suitable. I have made many many cantilever bridges and it is a very reliable and long lasting. It does involve butchering the tooth adjacent, but many cases are already crowned so no further butchering required. All treatments involve risk, thats why we have treatment options and informed consent.

Huntsman

Original Poster:

8,225 posts

257 months

Monday 10th January 2022
quotequote all
fourfoldroot said:
A cantilever bridge involves usually just butchering one tooth next to the gap. It is a final year favourite exam question to write an essay discussing the treatment options for the replacement of a single missing tooth. I merely suggested two courses of replacement but many others are possible. If funds allow, then an implant is treatment of choice if acceptable and suitable. I have made many many cantilever bridges and it is a very reliable and long lasting. It does involve butchering the tooth adjacent, but many cases are already crowned so no further butchering required. All treatments involve risk, thats why we have treatment options and informed consent.
Thank you. Helpful.

Just looked at your profile, TR4 very nice.

Huntsman

Original Poster:

8,225 posts

257 months

Wednesday 2nd February 2022
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My dentist was insistent that I needed a new bridge and that it needed to be mounted on the two teeth either side. I wasn't happy with that, since the longest run I'd had with the old one glued into place was with it glued to just one tooth.

So I went to another dentist, she said she thought it needed replacing, the replacement would have just one wing on the back, she offered to glue the old one back in to see how it went, I really wanted her to take impressions for a new one, but no, she wanted to glue the old one in, so I went with it.

It stayed in place for 4 hours. Humph.

I went back, she agreed it needed to be a new one, but said it would need 2 wings on the back! I said she needed to make her blimmin mind up!

Due to lack of clarity around whether a new bridge should be single or twin wing, I decided to go for a denture, if I don't get on with it I can revisit the bridge idea.



Escy

4,037 posts

156 months

Wednesday 2nd February 2022
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Why didn't you just get another 2 wing maryland, you got 30 years out of the last one. That's as good as it gets.

Huntsman

Original Poster:

8,225 posts

257 months

Wednesday 2nd February 2022
quotequote all
Escy said:
Why didn't you just get another 2 wing maryland, you got 30 years out of the last one. That's as good as it gets.
It started as a 2 wing, but for the last 17 years it only had 1 wing. While one dentist managed to make it stick on for 15 years, none of the other seem able to make it stick or be clear about 1 wing or 2.

Escy

4,037 posts

156 months

Wednesday 2nd February 2022
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Don't get hung up on the number of wings. One or two wings is a decision to me made by the dentist, based on how mobile your teeth are, what your occlusion is like, and aesthetic concerns amongst other things. The larger the surface area for the wings, the better the adhesion is likely to be. The back of the teeth can be prepared with groves or holes to improve retention.

The difference between a good and bad maryland is usually down to how well it's been fitted.


fourfoldroot

601 posts

162 months

Wednesday 2nd February 2022
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As Escy says in his last sentence, they have to be done well,and are very technique sensitive. Due to the nature of bonding between the etched tooth and cement/adhesive, and maryland metal and cement/adhesive, once they are debonded, a recement is usually less successful. Have a read up on acid etching and bonding for teeth.
For a replacement maryland, the previously etched enamel has to be ground off or it will not etch properly and the new bridge will have short life. Modern adhesive cements are getting better and better.
A denture is not an unreasonable option for tooth replacement whilst you find a good dentist. That’s the hardest part!

Armitage.Shanks

2,446 posts

92 months

Wednesday 2nd February 2022
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omniflow said:
DO NOT DO THIS - have an implant instead. You'll only be needing one implant. If you have a cantilever bridge you could end up needing 3 implants.
Whilst I'd agree an implant is the gold standard it's a bit far fetched to suggest a cantilever bridge will result in implants. My Crowns lasted 40yrs and my bridge 20+ yrs.

I'm no expert but going through some detailed treatment including implants at present in my mid 50s I decided to get my teeth sorted and something I should have done years ago but what was available v cost back then ruled it out. I've documented my Turkish dental treatment on here and my rationale for going abroad to have it done against the advice of one dentist on here who advocates you shouldn't go anywhere outside the UK for dental treatment. No, you could just stay in the UK and pay three times the price rolleyes