Maryland Bridge Before an Implant Crown?
My daughter has a congenitally missing lateral incisor. We’ve finished orthodontics and plan to eventually get her a dental implant to replace it. She’s too young for one right now. Our dentist suggested that we get her a Maryland Bridge as a temporary tooth replacement until she is old enough. The problem is the Maryland Bridge just won’t stay on. She’s tried different cements but that didn’t work. We were using ceramic wings. The dentist thinks that may be the problem. So now she’s thinking about giving her metal wings. I’m a bit worried. It will be about five years before she can get a dental implant. I have some questions that have me worried. Will the metal wings adhere that long? Will they damage the adjacent teeth that they are being attached to? Will people be able to see the metal behind her teeth?
Carol
Dear Carol,
I’m glad you wrote. First, let me say that I am glad you picked a dental implant for her permanent tooth replacement. It is the best tooth replacement you can get her.
I am not sure why your dentist recommended a Maryland Bridge for your daughter. One of the reasons that your daughter’s Maryland Bridge is not staying on because cement isn’t enough for this type of tooth replacement. There actually needs to be a bit of a notch made into the tooth, like you see in the image above. Because of that, I would not consider it a temporary tooth replacement. Once she is old enough and your remove the Maryland Bridge, that notch will have to be filled in with dental bonding material. So, yes, it will damage the tooth.
I would not let her do the metal wings. They will not stay any better without the notch we talked about and they will stain her adjacent teeth.
Instead, I’m going to suggest that you get her a dental flipper. This will hold the space open, it is much less expensive than what your dentist is currently using, and it will not damage her tooth in any way. Then, once she is old enough for a dental implant, you can replace her tooth permanently.
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Dental Implants and Hockey
My son is a freshman in college and plays for the hockey team. He hasn’t been playing that long but lost a tooth, which sounds like a hockey stereotype but it happened. We’d planned on getting him a dental implant. The prosthetic implant is placed. The crown is coming as soon as the bone is integrated with the implant. However, one of his teammates, who is a senior and has a lot of experience told him that a dental implant is a bad idea because he is likely to be injured again. Is that accurate? If so, what do we do? We want something that looks nice because he is getting married in a few months.
Lorna
Dear Lorna,
I had to think about this because I haven’t done much with hockey players in the past, but what the senior told your son makes sense. If your son is reinjured and the implant crown is attached to the prosthetic root, then it could do serious damage to his jaw by ripping through the bone. The good news is that you already have the prosthetic root in. This will protect him from bone resorption, which is one of the reasons dental implants are the best tooth replacement options.
My suggestion is that for now you get him a removable partial flipper for that tooth. This way if he does get in another accident the false tooth will not put his jaw at risk. If you go to a skilled cosmetic dentist, even a denture can look stunning. Once he is done with hockey, then you can have the permanent crown placed. It will be worth the investment to go to a top notch cosmetic dentist for this if you really want it to look perfect for his wedding.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.