Maryland Bridge as a Temporary Restoration?

I would love your advice. I have a 13-year-old son who has a lateral incisor that has always been missing. We’re done with the orthodontics to get everything in the right place. He’s currently too young for a dental implant, but that is what we want to get him eventually. We knew we’d need a temporary tooth replacement. Our dentist suggested a Maryland Bridge, but we’re having a heck of a time with it. Our dentist opted to use the ceramic wings but the next day the bridge fell out. He ordered a different kind of cement and we tried that, but again, the bridge fell out. Now, he’s talking about doing the metal wings. Here are my questions:
First, will the metal wings stay on better? Second, will the metal be visible through his teeth? He’s already self-conscious about his smile.

Monika

Dear Monika,

I think your dentist has good intentions but is in a bit over his head at the moment. One of the things he is struggling with is the bonding technique. The other is understanding the tooth preparation needed for a Maryland Bridge.

If you look at this image to the left, you can see that the tooth has a groove. This is necessary for proper tooth preparation with a Maryland Bridge. Because you didn’t mention it, I wonder if this was done.

Now, to answer your questions. First, will this stay on better? No. In fact, ceramic is a better choice when bonding to tooth structure. Metal does not bond as well. Given his struggle with the bonding technique as it is, I would not hold out much hope the metal will be the solution. Second, will you be able to see the metal through the tooth? Somewhat. It will darken his tooth. Instead of your dentist’s suggestion, I am going to recommend you go in a completely different direction.

I don’t consider a Maryland Bridge a temporary tooth replacement. This is because you have to change the structure of your son’s adjacent teeth to accomodate it with those grooves. Then, when it is time to remove the bridge, you’ll have to fill in those grooves with composite bonding.

I am going to suggest you get a dental flipper. This is a true temporary solution. No structural changes will have to be made. No bonding techniques are necessary for your dentist. And the best bit? It’s less expensive! A win-win.

By the way, your choice of a dental implant for him when his jaw is fully developed is a great choice. One word of caution. Make sure whoever you have to do his implant, has extensive post-doctoral training in implants. You don’t want someone inexperienced doing this. It’s a very advanced procedure.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.
Click here to learn about Holistic Dentistry.