My daughter had orthodontic treatment to make room to replace a genetically missing tooth. We needed a temporary tooth replacement in order to keep the space open for a dental implant a few years from now. Her dentist provided a Maryland Bridge with zirconia wings to blend better. Unfortunately, that fell off. She decided to try again but when it fell off the second time, she has decided we are going to have to switch to the metal wings in order to get it to stay better. I have a couple of questions. Will the metal show? Will the metal damage her teeth?
First, I’m going to say I’m glad you have chosen a dental implant for your daughter’s permanent tooth replacement. Great job in picking the top of the line replacement for her. Unfortunately, your current dentist isn’t top of the line. I don’t know the name of your dentist so none of this is said out of malice. She doesn’t understand the bonding procedure for a Maryland Bridge. Nor does she understand what a temporary replacement means.
Let’s start with the problem with her bonding and then I will answer your questions. She tried her traditional bonding method and it didn’t work. Rather than question the method, she questioned the material. Maybe I need metal instead of zirconia. Nope. That’s not the problem.
Maryland Bridge’s require some tooth preparation in order to stay bonded properly. Without that, the bridge will fail regardless of the type of wings your dentist uses. Grooves will need to be cut into her adjacent teeth, like what you see in the picture I’ve posted directly above. My guess is she didn’t do this type of tooth preparation, which is why it keeps falling off.
Now, to answer your questions. Will the metal show? Yes. It will darken the tooth structure. This is one reason dentists who use a Maryland Bridge are moving to the zirconia wings, which will keep the color unaffected. Your second question is will it damage your tooth? Yes, if she makes the grooves to properly attach the wings.
You could have her go back and do the grooves, but I’m going to recommend you switch temporary replacements here. One of the many benefits of dental implants is that the adjacent teeth aren’t impacted. To me, when you have to remove any structure from a tooth to use the replacement, it is no longer considered temporary. Instead, I’d like you to get a dental flipper for your daughter. This is truly a temporary replacement that she can take in and out at will. Good news for you is it is significantly less expensive than any type of dental bridge.
This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.