Hello friends, this is Dr. Stela Heisler. Today I want to talk to you about one of the most interesting and conservative solutions for replacing a missing tooth – the Maryland bridge. Over the years, I’ve treated many patients who came to my clinic in Jerusalem with a missing tooth, especially in the front area of the mouth, looking for a solution that wouldn’t require damaging healthy teeth. A Maryland bridge can be exactly the right answer in certain cases.
What is a Maryland Bridge?
A Maryland bridge, also known as an adhesive bridge or resin-bonded bridge, is a type of fixed dental bridge designed to replace a missing tooth in a minimally invasive way. Its name derives from the University of Maryland in the United States, where this technique was developed in the 1970s.
Unlike a traditional bridge that requires significant reduction of adjacent teeth, a Maryland bridge consists of a prosthetic tooth attached to thin metal or ceramic wings that are bonded to the back of the neighboring teeth. This means that preservation of natural tooth structure is maximized.
When is a Maryland Bridge Suitable?
I recommend a Maryland bridge in the following cases:
- Young patients – When dealing with young people who lost a front tooth in an accident or due to a developmental issue, and an implant is not yet recommended (usually until age 18-20).
- Healthy adjacent teeth – When the teeth on both sides of the gap are completely healthy, and it would be a shame to reduce them for a traditional bridge.
- Front area – Maryland bridges work best in the front tooth area, where bite forces are relatively low.
- Financial constraints – When a dental implant is beyond the available budget, a Maryland bridge offers a more affordable alternative.
The Process – What to Expect?
The process I perform at the clinic is relatively simple:
At the first visit, I perform minimal preparation of the supporting teeth – sometimes with no reduction at all, and sometimes only very slight shaping of the enamel on the back of the tooth. Then I take a precise impression of the teeth and send it to the dental laboratory.
At the laboratory, they build the bridge with custom fitting – the prosthetic tooth and the wings that will be bonded to the adjacent teeth. I make sure to choose quality materials that will match perfectly with the color of your natural teeth.
At the second visit, I bond the bridge using special dental glue and make fine adjustments to the bite and comfort. The entire process usually takes 2-3 weeks.
Advantages of a Maryland Bridge
From my experience, these are the main advantages:
- Preservation of natural tooth structure – This is the biggest advantage. We barely touch the healthy neighboring teeth.
- Excellent aesthetic result – When done correctly, a Maryland bridge looks very natural and blends perfectly with the rest of the teeth.
- Relatively quick procedure – Unlike an implant that can take months, here we’re talking about just a few weeks.
- Lower cost – The treatment is significantly cheaper than a dental implant.
- Reversible procedure – Unlike a traditional bridge that requires tooth reduction, here you can always remove the bridge in the future and move to another solution.
Disadvantages and Limitations
Like any treatment, a Maryland bridge also has limitations you should know about:
Lower durability – Bonding the wings is not as strong as anchoring a traditional bridge or implant. There’s a chance the bridge will debond over time, especially in people with grinding or heavy bite habits.
Not suitable for every location – In the back teeth, where bite forces are high, a Maryland bridge won’t hold up over time.
Requires maintenance – You need to maintain excellent oral hygiene and have periodic checkups to ensure the bridge remains stable.
Limited aesthetics – In some cases, the metal wing can be visible behind the supporting tooth, especially if there’s gum recession.
Care and Maintenance
If you’ve chosen a Maryland bridge, I always recommend to my patients:
- Brush teeth twice daily with fluoride toothpaste
- Use special floss that passes under the bridge
- Avoid biting very hard foods in the bridge area
- Come for periodic checkups at the clinic every 6 months
- If the bridge becomes loose or debonds – contact me immediately
Maryland Bridge Versus Other Alternatives
Many patients ask me what’s better – a Maryland bridge, traditional bridge, or implant. The answer depends on the specific case:
Dental implant is the preferred and longest-lasting solution in the long term, but it’s more expensive, requires surgery and a longer process. In young people whose bone hasn’t matured yet, or people with certain medical conditions, an implant isn’t always possible.
Traditional bridge is stronger and more durable than a Maryland bridge, but requires reduction of healthy teeth – something I prefer to avoid whenever possible.
Removable partial denture is the cheapest solution but the least comfortable and stable.
When is a Maryland Bridge Not Advisable?
There are cases where I don’t recommend a Maryland bridge:
- When the supporting teeth are weak or heavily restored
- In people with untreated teeth grinding habits (bruxism)
- When there’s a deep bite or significant occlusion problems
- In the back tooth area where bite forces are high
- When there isn’t enough space for the wings behind the supporting teeth
Over the years, I’ve seen excellent results with Maryland bridges in young patients who lost a front tooth. It’s a great solution for those looking for a way to complete their smile without damaging healthy teeth, and willing to accept the fact that repair or replacement might be needed in the future.
If you’re considering this treatment, click here to schedule a consultation at the clinic with me. We’ll examine your specific case together, discuss expectations, and choose the most suitable solution for your needs and budget.
Remember – every mouth is unique, and it’s important to find the exact solution for you. A Maryland bridge is a great tool in my toolkit, but it’s not suitable for everyone. Together we’ll find the best way to restore your smile. I’d be happy to see you at the clinic in Jerusalem and help you find the perfect solution for replacing your missing tooth.
