Maryland Adhesive Bridge

The Maryland adhesive bridge: the perfect solution and an alternative to implants when a single tooth is missing.

With its innovative and natural design, this dental bridge offers a highly aesthetic solution to replace one or more missing teeth, either permanently or temporarily (while a dental implant heals).

Unlike traditional dental bridges, this bridge does not require grinding down neighboring teeth for its placement. Instead, it uses a metal or ceramic structure that is bonded to the back of the adjacent teeth, which means there is no need to file down healthy teeth.

Its greatest appeal lies in its ability to provide a natural and durable appearance. The material used is stain-resistant and adapts perfectly to the shape and color of your current teeth. This guarantees that no one will notice the difference between your natural teeth and the bridge.

Remember that the Maryland bridge not only improves your appearance but also restores the complete function of your mouth. You will be able to speak, eat, and laugh with confidence, knowing that your smile will stay beautiful for a long time.

Don’t settle for an incomplete smile. Discover how the Maryland bridge can transform your oral health.

What is an adhesive dental bridge?

To understand what a Maryland bridge is, we must first define what an adhesive bridge is as a dental prosthesis technique.

An adhesive bridge is a type of fixed dental bridge of one or more pieces. Instead of relying on a dental crown over a neighboring natural tooth (previously filed), it is supported directly on the healthy tooth, which is gently prepared to house a “wing” that is bonded with modern special adhesives.

This bonding can be done on different parts of the tooth:

• On the chewing surface (occlusal surface): this is the part teeth (premolars and molars) use to crush food. When the wing is embedded in a small step on this surface of neighboring teeth, we refer to it as a traditional adhesive bridge.
• On the back side (lingual surface): this is the side of the tooth that points towards the tongue, meaning its innermost part. When the wing is glued to this area, we call it a Maryland-style adhesive bridge.

So, what is a Maryland bridge?

It is a type of adhesive bridge that is supported from the back of neighboring teeth, using only custom-made flattened structures known as “wings”.

This way, it is not necessary to file or grind down the healthy teeth near the space where the missing tooth is to be recovered. Only when the wings are made of ceramic or porcelain is minimal grinding required to increase the strength of the structure.

They are a more affordable alternative than implant-supported crowns because they have the advantage of being a fixed bridge without the need for surgery to place a dental implant. However, lacking an artificial root to support it, its strength is lower and requires greater care.

Is the Maryland bridge an adhesive bridge?

Yes, the Maryland is a type of adhesive bridge. The main difference lies in the following aspects:

• Shape of the wings: flattened instead of stepped.
• Location of the wings: on the back of the tooth instead of the chewing surface.
• Number of teeth to replace: usually one, instead of several.
• Location in the mouth: mostly used on front teeth rather than back teeth.

Advantages of the Maryland bridge

• Natural appearance: the material used resists stains and adapts perfectly to the shape and color of your current teeth. This ensures no one will notice the difference.
• Restores chewing and speaking ability: you will be able to speak, eat, and laugh with confidence, knowing your smile will stay beautiful for a long time.
• More affordable than an implant: the installation procedure is much simpler and requires no surgery, lowering costs. Furthermore, it can be used temporarily for aesthetic emergencies.
• Minimally invasive: like all adhesive bridges, grinding on neighboring teeth is zero to minimal, which means there is no need for anesthesia
• No need for provisional teeth: by not filing down neighboring teeth, there is no need to protect them with temporary crowns during the process.
• Can be permanent or temporary: it can be used permanently or as a temporary solution in aesthetic emergencies or during implant placement (for example, if you lose a front tooth in an accident and must wait for the implant to heal).
• Goodbye to metal: In the past, Maryland bridges were made with metal wings that sometimes left a slight grayish tint visible through the natural tooth. Today, we use highly aesthetic options like zirconia or lithium disilicate, achieving a natural, metal-free result that blends perfectly with your smile.

Disadvantages of the Maryland bridge

• Supports moderate forces: being glued to neighboring teeth and lacking an artificial “root”, its strength is limited. For this reason, it is widely used on front teeth (incisors), which withstand less biting force than molars.
• Works best for replacing a single tooth: due to its moderate strength, it is recommended to replace only one tooth so the structure does not have to bear too much pressure.
• Requires excellent dental hygiene: having the wings glued to the back of the teeth makes it essential to maintain very rigorous cleaning in that area.

How does it work?

The Maryland bridge is placed using a special dental glue that guarantees a secure and durable hold.

The metal or ceramic structure is bonded to the back of neighboring teeth, creating a strong bond that holds the bridge in place. This technique reduces the need to grind the tooth and offers a more conservative, mouth-friendly solution.

Who is a good candidate for a Maryland bridge?

The Maryland bridge is an excellent option for those who have lost a tooth (preferably a front one, up to a premolar maximum) and wish to restore their smile aesthetically and functionally at a lower cost than an implant.

However, not all patients are ideal candidates. It is important to consult a trusted dentist to evaluate your case and determine if this type of bridge is right for you.

Factors to consider include age, enamel quality, gum health of neighboring teeth, as well as the patient’s daily hygiene habits.

When is a Maryland bridge NOT recommended? (Contraindications)

Honesty and responsibility are fundamental pillars of our service. Therefore, it is important to mention that a Maryland bridge is not the ideal option for everyone.

If you suffer from severe bruxism (teeth grinding) or have a very deep bite or crossbite, the excessive force could cause the adhesive wings to detach frequently. In these cases, we will evaluate you and offer the best treatment option to ensure long-term success.

Process of getting a Maryland bridge

The procedure generally involves several stages, including:

• Initial consultation: your dentist will evaluate the condition of your mouth, listen to your expectations, and answer all your questions about the treatment.
• Dental preparation: if you are a good candidate, the dentist will gently prepare the neighboring teeth and take molds (impressions) of your mouth.
• Bridge fabrication: the molds are sent to a dental laboratory, where they will craft a customized Maryland bridge that perfectly fits your characteristics.
• Bridge placement: once ready, an appointment will be scheduled to install it. The dentist will verify the fit and bond it to your neighboring teeth using a high-strength adhesive.
• Follow-up and care: after placement, it is vital to follow the dentist’s instructions and maintain excellent oral hygiene to ensure the bridge lasts for many years.

Care and maintenance of a Maryland bridge

Proper care and regular check-ups are essential to ensure your bridge stays in good condition. Here are some key tips:

• Strict dental hygiene: brush your teeth at least twice a day with a soft-bristled brush and floss daily to remove bacterial plaque and food debris. We invite you to read this article on the best practices in dental hygiene.
• Caution when biting: avoid chewing very hard or sticky foods that could unglue or damage the structure.
• Check-ups and follow-up: attend your regular dental controls for check-ups and professional cleanings.
• Incidents: if you feel any discomfort or notice the bridge is loose, contact your dentist immediately to have it fixed.

How long does a Maryland bridge last?

Its lifespan depends on factors like your cleaning routine, gum health, and material quality. With proper care and regular dental visits, a Maryland bridge can last between ten and fifteen years, or even longer.

Cost of a Maryland bridge

The price can vary depending on case complexity, materials used, and the dentist’s experience. It is important to consult the clinic to get an exact quote and clear up your doubts before starting treatment.

In Quito, Ecuador, you have the advantage of accessing high-quality dental treatments at very affordable prices.

Other options besides the Maryland bridge

Although the Maryland bridge is an excellent option, there are other alternatives that might be more suitable depending on your case. Some of these include:

• Implant-supported crowns: this is the most natural, long-lasting¹, and resistant option in the long term.
• Traditional adhesive dental bridge: ideal for replacing back teeth (molars) that require sturdier support.
• Removable partial dentures: this is the most common option if you are missing several teeth.

It is essential to evaluate all these options with your dentist to choose the best solution based on your mouth’s needs.

Conclusion

The Maryland bridge offers an excellent aesthetic and functional solution for those wishing to recover their smile after losing a tooth. Thanks to its minimally invasive design, the use of high-quality materials, and its ability to avoid damaging neighboring teeth, it provides long-lasting and very natural results.

If you are looking for a reliable and aesthetic solution, and a dental implant is not viable at this time, consider the Maryland bridge as an ideal alternative, either temporarily or permanently.

Visit your dentist to get more information and take the first step towards a complete and healthy smile. Don’t settle for an incomplete smile!

References

1. Balevi, B. Root canal therapy, fixed partial dentures and implant-supported crowns, have similar short term survival rates. Evid Based Dent 9, 15–17 (2008). https://doi.org/10.1038/sj.ebd.6400565 ↩︎

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