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Maryland Bridge or Implant When Need Bone Transplant?

Question:

Janine Asks:

My daughter's adult tooth, second over in the front, never developed. We have taken her to a specialist and he said we had two options: 1. A Modified Maryland Bridge or 2. An implant. But, she does not have any bone to place the implant so they would have to take bone from the hip and do a transplant to make that happen.

We don't want to put her through a bone transplant, but still have concerns about the bridge. Is it strong enough to withstand biting into things? Are there any dangers of the holes made in the healthy teeth to put in the modified bridge?

Answer:
Answered by: Dr. Carlos Boudet

West Palm Beach, FL

Dear Janine:
I assume that you are talking about the lateral incisor, which is one of the teeth that are missing occassionally in the adult dentition.

If your daughter is younger than 18, an implant should be postponed until she finishes growing, and dentists usually suggest a Maryland Bridge or "acid etched bridge" because it spares the adjacent teeth from unnecessary reduction or grinding to support a conventional bridge, where "caps" or crowns are used to hold the missing tooth to the adjacent teeth.

A Maryland bridge is not as strong as a conventional bridge and many dentists use it as a conservative solution for a limited number of years while the patient grows old enough to receive a dental implant.

Your daughter may need a graft in the area of the missing lateral, but this graft is usually not a hip graft. It can be done with commercially available particulate graft materials(it looks like coarse sand) or in some cases it is taken from another area of the mouth. Both with great success in the hands of experienced practitioners.

If her teeth are in good shape, she would be better served by not reducing them and replacing the missing one with an implant.

Hope this helps.

Carlos Boudet, DDS, FICOI
http://www.boudetdds.com



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