Maryland Bridge Case Study - Fixing What Not to Do

Case Background

This patient was a mid-twenties female with a dental history significant for a congenitally right lateral incisor and a left peg lateral incisor. She had been through orthodontics and had the space restored with a PFM type Maryland bridge. The pontic had poor tissue profiles, and was in hyperocclusion with the lower anteriors. Additionally, the metal retainers were creating a gray appearance to the adjacent teeth.

Case Treatment

Diagnostic casts were taken, and a full contour wax-up was prepared. The existing bridge was removed and an ovate pontic space was created using a diode laser. The opposing lateral had a minimal preparation for a veneer in enamel. Provisionals were placed using a putty matrix made from the wax-up. Three weeks later tissue had healed well. The provisional restorations were removed and fiber core/composite Maryland bridge was cemented with an Empress veneer overlay. A single Empress veneer was placed on tooth #10.

Post Op

The patient was seen a week later to check on tissue contours, final polishing, final occlusion check, and minor embrasure changes.

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