I have two dental implants and just lost the tooth that is between them. My dentist is tinkering with the idea of putting a Maryland Bridge between them. Have you had experience with this type of restoration? Does it work okay to put a Maryland Bridge between two crowns?

Reuben

Dear Reuben,

I don’t think this is going to be your best viable solution for a few reasons. First, while a Maryland Bridge sounds easy to place on the surface, it is actually a bit more complicated than most dentists think. The best material to bond it to is tooth enamel. In your case, that isn’t an option. Your dentist will be trying to bond it to porcelain, which is harder.

Secondly, for a Maryland Bridge to have any security they need a groove etched into the adjacent teeth for the wings. Because you have a dental crown, there is a good chance it the groove will end up taking things to the metal base which makes it even harder to retain.

Ideally, your dentist would have anticipated that with two dental implants you might one day need a third. Then he or she could have made the implants parallel to one another and used screw-retained crowns. This way, if you lose the middle tooth, it becomes a simple matter of turning your two crowns into a dental bridge.

Seeing as that is not possible, I would first suggest seeing if you can fit a third dental implant in there. That would give you the most secure retention.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.