For many years, dentists had to reduce healthy teeth as abutments for fixed bridges. Now, with the Maryland Bridge, an ultra-conservative treatment option is available that enables the dental practitioner to splint or replace missing teeth esthetically, with an absolute minimum of supragingival tooth modification. Combining a microfilled-composite resin cemented to acid etched enamel and an electolytically acid etched or silicoated cast metal framework, the Maryland Bridge improves the bond strength of the restoration three-fold over earlier perforated resin-bonded retainers.

Current second-generation designs and tooth preparations, coupled with improvements in cementing resins which rely on adhesive rather than an etched metal system, have provided even more exciting and reliable restoration possibilities. Adhesive cementation of the alloy to the tooth structure allows the casting to be supported by abutment teeth. Bonding also prevents displacement back along the path of insertion. Because displacement of the casting in all directions other than along the path of insertion is prevented by alloy engaging tooth structure, the framework design limits the stresses placed on the luting agent and bond, dramatically increasing the longevity of the restoration.

Ultra Conservative Preparation
With the Maryland Bridge, fixed partial dentures, periodontal splints and a variety of other conservative restorations can be placed with a minimum of tooth modification. Abutment teeth are basically left intact - one unit is not weakened in the process of replacing another. Modifications are restricted to rest preparations and recontouring of the enamel is only required in severely undercut cases. All tooth preparations are supragingival, making modifications kinder to the periodontal tissues and impressions easier to obtain. By avoiding preparations involving dentin, sensitivity is virtually eliminated either from the preparation or subsequent cementation procedure. Most importantly, as the Maryland Bridge requires little or no removal of tooth structure, the treatment is often reversible.

Superb Esthetic Result
Labial metal collars create difficult esthetic problems when the patient has a high lip or smile line, a problem that is compounded where the gingival tissues are thin and fragile. Crowns with subgingival margins are only a temporary solution as the gingival tissues will recede over time leaving the margin visible. Since the Maryland Bridge does not extend into the labial or buccal surfaces, and the pontic can be custom stained, excellent esthetics are assured.

Proven Effective
The Maryland Bridge has been used successfully for over 20 years for both anterior and posterior prostheses. The quality and design enhancements of the current cast resin-bonded bridge has been proven successful both as a transitional and/or permanent prosthesis, particularly where there is a reluctance to perform extensive reduction on a sound tooth.