The Maryland Bonded Bridge

The Maryland Bridge, also known as a resin-bonded bridge, is one of the most conservative solutions available for replacing a missing tooth, especially in the front of the mouth where aesthetics matter most. Unlike traditional bridges that require crowns on neighboring teeth, the Maryland Bridge relies on metal or porcelain “wings” bonded to the back surfaces (the lingual side) of the adjacent teeth. These wings support a pontic that fills the space, creating a seamless appearance with minimal alteration of healthy tooth structure.

Indications:

• Replacement of a single missing tooth, particularly an incisor or canine.
• Young patients whose jawbones are still developing, making them unsuitable for implants.
• Adults with healthy, unrestored adjacent teeth who prefer to avoid drilling or full crowns.
• Interim or transitional restoration before implant placement in certain orthodontic or surgical cases.

Patient Suitability Considerations:
The Maryland Bridge is an excellent option when the surrounding teeth are intact and free of large restorations or crowns, as it preserves nearly all of their natural enamel. It’s also ideal for patients who value minimally invasive dentistry or wish to delay surgical options such as implants for financial or medical reasons.

In cases where the adjacent teeth already have crowns, a traditional bridge may be more practical. However, for a patient with pristine, untouched enamel, it would be counterproductive to drill away healthy tooth structure. In these scenarios, a Maryland Bridge offers the perfect balance of function, aesthetics, and preservation. It is also a cost-effective option, providing a fixed replacement without the expense of implants or extensive crown work.

Contraindications:

• Patients who clench or grind their teeth (bruxism).
• Large gaps or areas under heavy bite force (such as molars).
• Very translucent enamel, where metal wings might show through.

History & Key Point:
Developed at the University of Maryland in the early 1980s, this design revolutionized restorative dentistry by introducing a method to bond a replacement tooth without removing natural enamel. While early versions used metal wings, modern iterations often use porcelain or fiber-reinforced materials, improving both strength and aesthetics. The main limitation remains debonding — if a wing loosens under stress, it may need to be re-bonded.

Fun Fact:
The Maryland Bridge is one of the few “additive” dental restorations — it builds onto existing tooth surfaces rather than removing them. In most cases, the entire procedure can be completed without local anesthesia!

FAQ Highlights:

• How long does it last? Typically 5–10 years, depending on bite pressure and oral hygiene. If debonding occurs, it can often be easily reattached.
• Is the metal visible? Rarely, as the wings are bonded behind the teeth. For optimal aesthetics, porcelain or composite wings can be used instead of metal.
• Can it be replaced later with an implant? Yes — the Maryland Bridge makes an excellent interim restoration until an implant becomes feasible.