Conservative approach for replacing missing teeth: A case report

Resin bonded bridges can be highly effective in replacing missing teeth, restoring oral function and aesthetics and result in high levels of patient satisfaction. They represent a minimally invasive, cost effective and long lasting treatment modality given thorough patient assessment and the use of careful clinical techniques. Maryland bridges should be considered more frequently as the restoration of choice for short spans. Maryland bridges are resin bonded bridge using electrolytic etching of metal to retain the metal framework. Thompson and Livaditis in 1983 developed a technique of electrolytic etching of Ni-Cr and Co-Cr alloy. Etched cast retainers have definite advantage over cast perforated restorations. Retention is improved as resin to etched metal bond is substantially stronger than resin to etched enamel. In one study it was found that an electrochemically etched surface was approximately 2.9 times as retentive as a perforated one. Retainers are thinner and non-perforated. Oral surface of cast retainers is highly polished and resists plaque accumulation. Whole surface area of retainer is retentive adding to retention. But etch is alloy specific requiring special apparatus. Only non-precious alloy which can be etched is used. Precious alloys cannot be etched. Micromechanical retention in noble alloys is achieved by electrolytic tin plating. Other means of micromechanical etching is Grit blasting using 50 – 250 µm Aluminium Oxide. Chemical etching can be achieved by Hydrofluoric Acid gel (Livaditis 1986) and Aqua Regia Gel. Keyword: Maryland bridge, Interim Prosthesis, Resin bonded prosthesis