Maryland Bridge (Bonded Resin Retainer)

The Maryland bridge, or bonded resin retainer, is an alternative to implants and conventional crowns to replace missing teeth. This type of replacement procedure can be considered when the space to be restored is next to teeth in good alignment that are not heavily restored with filling materials. Because this type of bridge is adhesively bonded to the enamel on the abutment teeth, having adequate enamel is important. A Maryland bridge is fixed into place and is not meant to be removed at night.

Maryland Bridge vs. Fixed Bridge

One advantage of this process over a conventional bridge is that a missing tooth can usually be replaced with a minimum amount of preparation (drilling) of the remaining teeth. It is not necessary to prepare the tooth to the same extreme degree as with full tooth coverage restorations (crowns or caps). This method is an extremely conservative procedure. It is also less expensive (about one quarter less) than a conventional bridge. Tissue health around the abutment teeth is usually excellent because little or no preparation of the tooth structure near the gingival (gum) tissues is needed. Unlike conventional full coverage restorations, teeth prepared for a Maryland bridge retainer will not need endodontic treatment (root canal therapy) at a later date.

If the patient has abusive eating or bruxing (grinding) habits, this type of restoration is contraindicated. Although we do consider it more of a restoration for posterior (back) teeth rather than anterior teeth, it does display metal more so than a conventional bridge. The biggest disadvantage of a Maryland bridge is that the expected life may not be as long as that of a conventional bridge made of full coverage crowns. This technique was only introduced in the early 1980s and therefore does not have the extensive successful history of full coverage bridges. While breaking of a Maryland bridge is not likely, debonding can occur, requiring a re-cementation. In some rare instances, it might have to be redone. In either case, you may be charged a fee for the procedure. A Maryland bridge is a fixed replacement for a missing tooth, but one that will need to be redone in the future. The success rate at 5 years of Maryland bridges in our practice is approximately 80%. However, this is a much better result than the national average, which shows a success rate of about 33% at 4 years. Maryland bridges are most appropriate for single-tooth replacement. 

If dental implants are not an option for you for tooth replacement and you do not want the teeth on either side of the space to be radically prepared (cut down or drilled), then you should consider the Maryland bridge technique. For many patients, the advantages of less drilling of the teeth and the reduced cost make it a desirable alternative.

If you have any questions about the Maryland bridge technique, please feel free to ask us.