52. Technology of fixed bridge restorations with resin-bonded retainers - Maryland retainers.
Explains resin-bonded bridges with Maryland retainers, which replace a single tooth by bonding thin metal wings to the enamel of neighbouring teeth. Traces the development from Rochette and Maryland designs to today's sandblasted metal with adhesive resin, then covers indications and contraindications, enamel-only preparation rules, laboratory steps, the bonding sequence, and advantages against disadvantages, with tables and a diagram.
Topic 52 of 75 in the MU Sofia syllabus for Preclinics of Dental Prosthetics (Dental Medicine, Year 2). The free AceMed note covers it in 7 sections, about 173 words (2 min of reading), with 14 flashcards.
In this note
Introduction
Development
Indications and contraindications
Preparation (in enamel only)
Laboratory work
Bonding
Advantages and disadvantages
Introduction
A resin-bonded bridge holds the pontic with thin metal wings glued to the enamel of the neighbouring teeth, instead of crowns. It is the most conservative fixed way to replace a single tooth: the abutments are barely prepared, and the preparation stays in enamel.
Preparation (in enamel only)
Reduce the lingual surface by about 0.5 mm so the wing doesn't open the bite.
Make proximal grooves or slots for resistance to displacement.
Add occlusal or cingulum rests for vertical support.
Design the wing to wrap about 180° around the tooth for good resistance.
Keep margins supragingival.
Laboratory work
The wax pattern is made on a refractory (investment) cast or a stone cast with removable dies, and cast in a base-metal alloy (nickel-chromium or cobalt-chromium), which is stiff enough to be very thin. The pontic is veneered with porcelain or composite.
Bonding
Try in; check fit and occlusion.
Sandblast the inner surface of the wings; apply metal primer.
Isolate (rubber dam), clean the enamel, etch with phosphoric acid, rinse and dry.
Lute with an adhesive resin cement; remove excess; check occlusion.
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