Maryland Bridge Research Articles

Maryland Bridges: A Conservative Approach to Aesthetic Tooth Replacement – A Case Report

Restoring missing central incisors in the mandibular jaw is a challenging esthetic challenge in dentistry, especially for younger patients. Maryland bridges are a highly effective treatment option, restoring oral function and aesthetics, and resulting in high patient satisfaction. These bridges have advantages over conventional fixed dental prosthesis, such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. Provisional restorations are usually not required. Maryland bridges are cemented to the abutment tooth using electrolytic etching to retain the metal framework. The bond is strengthened after etching, and the development of resin cements has enhanced bridge retention. A missing anterior tooth poses an esthetic, functional, and rehabilitative problem, especially for younger patients. Resin bonded bridges are minimally invasive, offering advantages such as minimal removal of the tooth structure, minimal pulpal trauma risk, and reduced time and cost. This case report describes the fabrication technique for a single missing lower anterior tooth, focusing on conservative, economical, and esthetic treatment outcomes.

Computer-guided implant surgery and tooth-mirroring digital workflow to treat an esthetically compromised clinical case

Background: In multidisciplinary dentistry, it is common to observe clinical cases that present multiple complications at the end of orthodontic therapy, such as differences in gingival height, alterations in size and shape of the teeth, and reduced residual spaces for implant therapies. Aim: The aim of the study was to solve an esthetic case with the help of digitally assisted prosthetic and surgical design. Methods: A young patient had been treated orthodontically for the agenesis of tooth 12 and the conoid shape of tooth 22. Previous therapy consisted of opening the space for tooth 12 by positioning a Maryland-type composite bridge, followed by reconstruction with a composite of tooth 22. Various composite reconstructions on teeth 11 and 21 were no longer adequate. Furthermore, both elements had discordant coronal axes, the diastema was observed at the incisal level, and tooth 21 was approximately 1 mm longer than tooth 11. Radiographic analysis revealed that the roots of teeth 11 and 13 converge, providing sufficient space for the insertion of a small-diameter implant. An intraoral scan and cone-beam computed tomography (CBCT) were performed; both data files were merged using surgical design software. A surgical guide was developed for the insertion of an implant in site 12. After insertion, the composite bridge, which was no longer suitable, was removed and a new temporary metal-composite Maryland bridge was positioned. Using an artificial intelligence tool of the design software, tooth 22 was isolated, mirrored, inserted in site 12 to reproduce the gingival profile, and subtracted from the digital impression. A technician then copied this emergence profile to build a zirconia prosthetic crown to be screwed on the implant. Teeth 22, 11, and 21 were restored with a lithium disilicate crown and two veneers, respectively. Results: The initial digital design and the use of a guided surgery procedure allowed for the insertion of a small diameter implant without damaging the roots of the adjacent teeth. The prosthetic design procedure, using the digital tools of the design program, made it possible to standardize and create symmetrical gingival profiles of teeth 12 and 22. The overall composition was completed by the use of minimally invasive adhesive prosthetic techniques on teeth 11, 21, and 22. Conclusion: Digital resources have become essential tools for dental professionals. The knowledge and use of technologies like intraoral scanning and CBCT, combined with various innovations such as artificial intelligence in prosthetic and implant design software, enable dentists to manage even the most complex interdisciplinary clinical cases with greater confidence. Relevance for Patients: Digital techniques are now widely used across all fields of dentistry. This has led to the need for operators of all ages to adjust their decision-making process compared to traditional techniques. These new techniques have also improved communication with patients, allowing the dental team to have a clearer understanding of the clinical path to follow and consequently offer their patients precise dentistry solutions.

Maryland bridge for cleft lip palate patients

Maryland bridge for cleft lip palate patients

Cross wing Maryland bridge: An innovative approach ndash; case report

Cross wing Maryland bridge: An innovative approach ndash; case report

Zirconia-supported Maryland Bridges in Lateral Tooth Deficiency

Zirconia-supported Maryland Bridges in Lateral Tooth Deficiency

Upper Incisor Loss: Maryland Bridge to Implant Aesthetics

Upper Incisor Loss: Maryland Bridge to Implant Aesthetics

Vascularized Interpositional Connective Tissue Graft: An Alternative in Esthetically Demanding Regions. A Case Report and Literature Review

Objective: This case report aims to showcase the utilization of a vascularized interpositional pedicle connective tissue graft and a Maryland bridge as an alternative treatment to bone graft and implant placement. Clinical considerations: The case report illustrated the success of a well-thought-out alternative treatment plan to implant placement, achieving esthetically pleasing and functional results. Conclusion: The vascularized interpositional pedicle connective tissue graft can serve as a less invasive alternative that achieves an esthetically pleasing outcome.

Rehabilitation of Anterior Esthetics Using CAD-CAM Fabricated Zirconia Maryland Bridge: A Case Report.

Introduction: Missing anterior teeth have a great impact on the psychological status of an individual due to the unesthetic appearance. These can be restored using removable prostheses, conventional bridges, resin-bonded prostheses, or implants. A resin-bonded fixed prosthesis is a minimally invasive treatment option in such cases to restore function and esthetics. Case Presentation: This case report describes the CAD-CAM zirconia Maryland bridge as a treatment modality for effective restoration of the missing maxillary central incisor in a 32-year-old female patient who reported the chief complaint of unesthetic appearance. The patient had a history of extraction due to trauma 6 months ago with normal overjet and overbite. Discussion: One of the types of resin-bonded prosthesis is a Maryland bridge which involves minimal tooth preparation with supragingival margins, thus maintaining periodontal health. Maryland bridges enhance dental esthetics with minimal loss of tooth structure. Conclusion: CAD-CAM fabricated all-ceramic resin-bonded prosthesis is an efficacious way of replacing missing anterior teeth, restoring function, providing excellent esthetics, and thus boosting patient’s confidence. Keywords: CAD-CAM zirconia, Maryland bridge, missing anterior tooth, resin-bonded fixed prosthesis, resin-bonded restoration.

Dental Bridge Procedure to Straighten Loose Teeth, A Review

Background: A dental bridge is a treatment that fills spaces or gaps between teeth or fills in missing teeth. Bridges can help restore bite and maintain the natural shape of the face. The procedure for closing or making abutments between the gaping tooth spaces uses dentures (called pontics). Objective: Report and explain the dental bridge process to straighten loose teeth. Materials and Methods: Based on the author's knowledge, this review included theory or case studies from Elsevier, Willey, MDPI, Hindawi Publishing, Dove Press, and Pubmed journals. Several (35 articles) of these manuscripts are then identified for appropriateness with the subjects provided in this study, assessed descriptively, and described based on the manuscript's flow or scientific principles. Results: Pontics are made of porcelain to match the natural color of the teeth. After the pontic is implanted, there is no more space between the teeth. In general, this procedure is needed to: Restore the teeth's ability to bite and chew, Clarify speech when you speak, Maintain facial shape, and Prevent remaining teeth from falling out or shifting positions. Four types of dental bridges are an option to "bridge" the empty dental space: Traditional bridge, Cantilever bridge, Maryland bridge, and Implant-supported dental bridge. Pontic installation through this process must be repeated every 5-15 years, depending on the type of treatment. This paper reports several types of dental bridges that can be used as references to improve understanding of prosthodontics. Conclusion: A dental bridge uses dentures anchored to teeth or implants to replace lost teeth permanently, improving speech, restoring a smile, and preventing tooth loss

Dental Treatment Approach in an Adolescent Patient With Coffin-Siris Syndrome

Coffin-Siris Syndrome (CSS) is a rare genetic disease with delayed growth, congenital anomalies, abnormal facial features, and mental retardation. Hypoplasia of the 5th fingers or nail agenesis, hirsutism, coarse facial appearance, thick eyebrows, wide lips and nose, dentofacial anomalies, and delayed eruption of teeth are clinically distinctive features. Specific findings and multidisciplinary approac-hes are important for dental treatments. This case report includes the clinical, oral findings, and dental treatments of the patient with CSS. A 15.5-year-old female patient consulted our clinic with the complaint of tooth sensitivity and missing teeth. The patient's family was informed that the patient has CSS. In clinical examination, coarse face, mental retardation, hypoplastic 5th fingers, wide mouth, and lips, sparse hair, and hirsutism, in the oral examination, poor oral hygiene, dental caries, delayed dentition, lack of upper perma-nent first incisor, gingival hyperplasia, gingivitis, and hypoplasia were seen. Panoramic radiography and tomography revealed that the upper permanent incisor and supernumerary canine teeth were impacted. Under general anesthesia, dental scaling, fillings were made, impacted permanent incisors, canine, and lower left third molars were extracted. After general anesthesia, fluoride application and a fiber-supported Maryland bridge designed from the patient's teeth were applied to the anterior region. Regular controls of the patient continue. After the growth and development, the oral surgery department will be consulted for implant application. In den-tistry, preventive applications, oral hygiene motivation, pharmacological and non-pharmacological treatments are important for CSS patients. After consultation with relevant departments, multidisciplinary approaches and appropriate treatments increase the quality of life.

Presenting a Protocol for Dental Implant Restorations

This case report focuses on applying a protocol for dental implant restoration in aesthetic zones, specifically the anterior sectors. The protocol aims to achieve optimal results with minimal complexity, reducing the number of sessions and impressions required for transferring clinical information to the laboratory. The historical development of dental implantology and the evolution of dental implant restoration workflows are discussed, highlighting the significance of osseointegration and advancements in materials, surgical techniques, and prosthetic components. The case report describes rehabilitating congenitally missing lateral incisors using fibre-reinforced composite Maryland bridges for provisional restoration and Osstem TSIII (Osstem®, Seoul, South Korea) implants, zirconia abutments, and disilicate lithium crowns for definitive repair. The discussion covers essential aspects of aesthetic dental implant restoration, including materials, types of dental implants, surgical techniques for soft tissue enhancement, and prosthetic and impression techniques. The study emphasises the importance of selecting appropriate materials, employing advanced surgical procedures, and utilising accurate prosthetic and impression techniques to enhance the aesthetic outcomes of dental implant restorations. A multidisciplinary approach and patient-centred care are essential for successful aesthetic dental implant restorations. The methodology presented in this manuscript demonstrates its effectiveness in achieving optimal outcomes while minimising stress on soft tissues and improving patient comfort and satisfaction. This case report contributes to dental implant restoration, providing evidence-based techniques for achieving aesthetic and functional success.

Orthodontic-prosthetic rehabilitation of alveolar cleft

ABSTRACT This case report presents the treatment of an 18-year-old girl with a unilateral alveolar cleft and impacted deciduous teeth. The patient had a gap in her upper front teeth and sought treatment for the alveolar defect. The initial treatment plan included alveolar bone grafting, fixed mechanotherapy, and prosthetic rehabilitation. However, the patient declined the bone grafting surgery. To address the issue, orthodontic treatment began with the extraction of a lower incisor to correct the overjet and the removal of over-retained deciduous teeth and a resorbed lateral incisor. The impacted lateral incisor was brought into the arch to stimulate bone formation. The treatment lasted 21 months, and an interim prosthetic rehabilitation with a natural tooth pontic was placed before the final rehabilitation using a Maryland bridge. The outcome of the treatment showed improved dental esthetics, harmonious soft-tissue profile, and parallel roots. This case highlights the importance of early intervention for alveolar clefts and the collaborative effort required for comprehensive oral rehabilitation in cleft lip and palate patients.

Dental Bridge Procedure to Straighten Loose Teeth, A Review

Background: A dental bridge is a treatment that fills spaces or gaps between teeth or fills in missing teeth. Bridges can help restore bite and maintain the natural shape of the face. The procedure for closing or making abutments between the gaping tooth spaces uses dentures (called pontics). Objective: Report and explain the dental bridge process to straighten loose teeth. Materials and Methods: Based on the author's knowledge, this review included theory or case studies from Elsevier, Willey, MDPI, Hindawi Publishing, Dove Press, and Pubmed journals. Several (35 articles) of these manuscripts are then identified for appropriateness with the subjects provided in this study, assessed descriptively, and described based on the manuscript's flow or scientific principles. Results: Pontics are made of porcelain to match the natural color of the teeth. After the pontic is implanted, there is no more space between the teeth. In general, this procedure is needed to: Restore the teeth's ability to bite and chew, Clarify speech when you speak, Maintain facial shape, and Prevent remaining teeth from falling out or shifting positions. Four types of dental bridges are an option to "bridge" the empty dental space: Traditional bridge, Cantilever bridge, Maryland bridge, and Implant-supported dental bridge. Pontic installation through this process must be repeated every 5-15 years, depending on the type of treatment. This paper reports several types of dental bridges that can be used as references to improve understanding of prosthodontics. Conclusion: A dental bridge uses dentures anchored to teeth or implants to replace lost teeth permanently, improving speech, restoring a smile, and preventing tooth loss.

Replacement of Missing Anterior with Maryland Bridge using Ribbond: A Case Report

Replacement of missing mandibular central incisor is difficult challenge in esthetic dentistry. Resin bonded bridges or maryland bridges can be considered as a treatment of choice in such conditions, which restore the oral function and esthetic of the patient. Maryland bridge preparation requires minimal preparation of the tooth and the bridge can be attached to the periodontally sound adjacent teeth.The combined use of polyethylene fibre and resin composite help achieve durable and functional result.This case report describes the case of esthetic restoration of a young women with midline spacing of mandibular anterior teeth.

Modified zirconia-bonded M-bridge for prosthetic rehabilitation of missing anterior tooth in a young adolescent

A space in the maxillary anterior region of the dental arch can produce a huge psychological impact on the young patient due to the unesthetic appearance of the teeth, necessitating immediate care for esthetic and functional rehabilitation. Trauma due to avulsion accounts for 0.5%–16% of all traumatic dental injuries to permanent dentition. Despite the availability of a variety of therapeutic treatments, including implants and removable partial dentures, these solutions have several drawbacks. Challenges range from poor wear compliance, growth disruption when used on young patients, and the inability to endure strong masticatory stresses. For the replacement of a missing tooth, resin-bonded bridges offer a minimally invasive, practical, cost-effective, and time-saving alternative. Maryland bridge is a type of resin-bonded bridge, the simplest, and most popular due to its micromechanical retention property. However, its disadvantages include esthetically unappealing and dislodgment of the prosthesis. Therefore, modifications may be introduced in the design of the bridge to address these limitations. The present case report illustrates a clinical case of prosthetic rehabilitation in a young patient utilizing modified zirconia-bonded M-bridge in conjunction with additional structural changes and can be considered as highly reliable early rehabilitation.

High Patient’s Acceptance of Maryland Bridge: A Minimal Procedure Following Dental Trauma

Traumatic dental injuries are more prevalent in permanent than primary dentition, in which maxillary incisors are more affected. The global prevalence of traumatic tooth injuries ranges from 6 to 37%. According to one study, out of 1,657 schoolchildren (aged 5-8 years) surveyed, 2.7% had traumatic injuries to their anterior teeth. A completely knocked-out front tooth often occurs as a result of a traumatic dental injury, which produces psychological and functional distress for the patient and should be treated immediately. There are various treatment options such as reimplantation, removable partial dentures, or fixed dentures, which are often not applicable or inconvenient for the patient, especially in young patients where bone growth is ongoing. Therefore, a resin-bonded fixed partial denture such as Maryland bridge is a treatment option for young patients who needed a replacement for missing anterior teeth before their growth and development was fully complete.

MODIFIED VERSION OF ADHESIVE BRIDGE, CLINICAL CASE REPORT

 Restoration of primary and secondary partial adentia with adhesive bridges (Maryland bridges) is an achievement of Practical Odontology. This scientific article covers correction of aesthetic and functional discomfort caused by one tooth loss, using a splint. Despite the authors rich clinical experience in modeling of composite adhesive bridges (227 patients and 253 modeling teeth), it is not common in practice to use man’s own tooth in restoration of partial adentia. The article describes a clinical case of a patient, who lost tooth due to localized periodontitis. The 2.1 tooth restoration was made not with composite crown attached to adhesive splint (INTERLIG, Angelus), but with own extracted 2.1 tooth. The clinical result was satisfactory. Maximum harmony was gained between modeling adhesive bridge, smile line and occlusion.

Resin-Bonded Prosthesis in Posterior Area to Prevent Early Marginal Bone Resorption in Implants Placed at Tissue Level

Aim: To evaluate the effect of the resin-bonded prosthesis (Maryland bridge) on marginal bone remodeling of implants placed at the tissue level in the posterior region. Methods: Consecutive healthy patients (n = 46) were included in this clinical study. Flapless not-submerged implants were placed with cover screws exposed and positioned approximately 0.5 mm above tissue level. Patients received the implant and a temporary resin-bonded prosthesis (RBP) (n = 22) or only the implant (n = 24). The RBPs were kept in place for 3 months and removed before impressions. The implants received a custom-made abutment and provisional resin crowns followed by definitive cemented metal–ceramic crowns after 2–3 weeks. The marginal bone level (MBL) was evaluated in a single-blind condition on scanned periapical radiographs and assessed mesially and distally (MBL-M/MBL-D). The bone levels of adjacent teeth (CEJ-M/CEJ-D) and the modification of the area between the implant and the mesial/distal teeth (Area-M/Area-D) were measured. All measurements were made at 1, 3 (pre-loading time) and 12 months (post-loading time). Linear regression models were fitted to evaluate the existence of any significant difference. Results: A total of 44 patients (20 Female, 24 Male; Mean age: 53.9 ± 10.3) completed the study. Two patients were excluded for fractured RBP or de-bonding. The drop-out was of 4.3%. After 12 months, all implants were free from complications. No peri-implantitis or mucositis were observed. The RBP group showed the most stable MBL at 12 months (−0.07 ± 0.41), statistically different from the non-RBP group (−0.67 ± 0.52). CEJ-M and CEJ-D were stable in both groups. Conclusion: The proposed approach of the use of RBP creates a more stable marginal bone level around implants placed at the tissue level, resulting in a reliable technique to protect bone tissue from mechanical and occlusal trauma during the healing period and osteointegration.

Maryland bridge as a minimally invasive treatment modality for missing anterior teeth: A case report

Missing anterior teeth in a young age produces a psychological impact on the individual due the unesthetic appearance of the teeth. Resin bonded fixed partial denture is a minimally invasive treatment option to restore the function and esthetics in such patients. Maryland bridge is a type of resin bonded bridge which has minimal potential to traumatise the pulp with supragingival margins which maintains the health of the periodontium. This case report describes Maryland bridge as a treatment modality for an effective restoration of the missing anterior teeth.

Single Anterior Tooth Replacement By Maryland Bridge With Loop Connector: A Case Report

Restoring a single missing tooth in the mandibular anterior region is often a great concern to the dentist because it requires unnecessary removal of healthy abutment tooth structure. Also because of the drifting of the teeth may reduce the available pontic space or presence of diastema before can result in excessive mesiodistal space which again compromises the aesthetics. When the patients demand more conservative and less invasive treatment options, a combination of Maryland Bridge with a loop connector may be the best alternative option to restore the missing teeth whenever the diastema is present. It is the modification of resin bonded FPD which offers a simple solution when the above dilemma is present. It consists of a loop on the lingual aspect, joining the pontic in the center, and then attaches to the wing retainer on the abutment tooth. This case report provides a straightforward and innovative method for the fabrication of modified resin bonded FPD along with maintaining diastema.