July 2006

Maryland bridge

R.Sathyanarayanan

This case deals with a conservative management of replacing the missing first permanent lower molar. There are many new conservative techniques for this type of fixed fixed bridges and this case is managed by one such technique to check the durability of such restorations. The operative photograph shows the occlusal rest preparation on the molar. Two wing extensions on the buccal and lingual surfaces of the molar and the premolar were taken as the retainers.

21inter-mary-2This is the immediate post operative image that shows the bridge in place. Unfortunately the bridge lasted only for four months after which it was dislodged. Examination revealed good marginal adaptation of the bridge. The cementation was done with resin cement after treatment with metal primer for the metal component. The same bridge was recemented again which dislodged after five months. The design was changed finally and the case is due for follow up. However this design may not be a durable design for the replacement of lower molars.