Question: Can a Maryland bridge be used if one of the abutment teeth already has a dental crown on it? I read that the back of the teeth have to have some work done to prepare the teeth..although not as much as for a traditional fixed bridge.

Answer: Traditional Maryland bridges have a metal foundation with applied porcelain and metal clasp arms for support – more recently Maryland bridges have been designed as all-ceramic (various different materials).  Both types are bonded to place.  The original design and thought behind this restoration was to be super-conservative, not preparing the teeth at all.  Creating a positive step, however, adds to the strength and stability of these bridges. 

So the positive aspects of these designs is that they require less tooth preparation, particularly handy for children or teenagers where we are trying to be super conservative.  The downside, however, is that these are bulky and are often bulky enough that it takes some time to get used to them.  They also are not super strong, especially when there is no tooth preparation.  Thus they come loose from time to time… good news, bad news… but when they do come loose, most of the time they can be cleaned up, sandblasted and re-bonded into position, using the same bridge.

Traditional fixed bridges do require more tooth preparation, with the benefit that usually we can restore contours that improve on original shape of teeth, and the bridges tend to last longer.  There are definitely indications for both types of bridgework.  Any type of fixed bridgework works better when the support teeth are tall and strong – much tougher when teeth are short, when teeth have large existing restorations in them, or when the patient has dominant, destructive muscular forces.  There are many variables.

Additionally, with the success of dental implants, we are doing fewer of all types of bridges, placing implants to replace missing teeth.

It is not a simple subject – you should have a complete dental exam with photos and x-rays and possibly study models to understand all of your choices – there are several.

 Houston Cosmetic Dentistry is a specialized field that requires extensive knowledge and experience to be done correctly. The Medical Center Dental Group in Houston, Texas brings all of that and more to the direct benefit of each and every patient we treat. Although we are located in the world famous Houston Medical Center at Scurlock Towers, we routinely see dental patients who travel from Austin, San Antonio, Dallas, Beaumont and Midland Texas to see Dr. Dale Brant, Dr. Charles Campbell for their cosmetic denistry services

Chuck Campbell, DDS
Dale Brant, DDS
713-795-5905