Category Archives: Dental Bridge

A Maryland Bridge in an MRI

I have a Maryland Bridge and am in need of an MRI. Is this safe or do I need to make other arrangements?

Carl

Dear Carl,

Diagram of a Maryland Bridge

While the Maryland Bridge is generally a non-precious dental alloy, it will contain some nickel and/or cobalt. These are metal, but it is unlikely an MRI will dislodge it. The reason I say this is because these dental bridges, whether a Maryland Bridge or traditional dental bridge, are made to withstand biting forces. As a result, an MRI is unlikely to have enough force.

BUT…

You knew there had to be a but coming, didn’t you?

Dentists are not MRI technicians. Because of that, I tend to refer people their MRI technician who would have more extensive knowledge on this. There used to be a website where you could look up this information, but I just went to check it and the domain has expired. Hopefully, it will be back.

Dental Work You Should NOT Wear in an MRI

Any removable dental work, such as a partial denture or a dental flipper should not be worn during an MRI. They will dislodge. Because they are easily removable, it won’t put any hindrance on your medical procedure. You can simply remove these items when you remove any rings, etc. you have

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Metal showing on my maryland bridge

I’ve had a Maryland Bridge for 20+ years. I’ve never had any problem with it. However, a week ago I needed a crown placed. In order to get a comfortable placement, my dentist had to adjust my bite a bit, which included grinding a bit on the Maryland Bridge. The next morning, I noticed a silver spot where the metal was showing through. I went back and he said the problem was likely because I grind my teeth. He bonded a composite filling on it, but that was gone by the next day. He still insists it is from my grinding and says there is nothing more he can do to fix it. I’m finding that hard to believe as I’ve not had a problem with this bridge until he messed with it. It’s a little intimidating to argue with him, though. What do you recommend here?

Penny

Dear Penny,

Diagram of a Maryland Bridge
Maryland Bridge

While I haven’t seen the tooth, I think you and I both know that he is the culprit here. However, he’s the dentist and therefore in the authoritative position which makes it tricky for you to confront him, especially if his pride interferes with his integrity.

One thing I’d like you to do is get a second opinion. Some dentists will even give you a free second opinion. They’ll be able to tell if he caused the damage. If you drag a metal explorer over glazed porcelain, it won’t leave a mark. However, if the porcelain has been ground on with a dental bur, a distinct mark on the porcelain will be visible.

Once the second dentist has armed you with the information you need, you may be able to get him to admit his error. In truth, every dentist has had this happen. The shame is more in not being willing to try and make it right.

A Possible Fix for Your Bridge

There is a possible way to fix this without having to replace the bridge. It is worth a try, though it doesn’t always work. When your dentist placed the composite filling. it doesn’t sound like he did anything to prepare the metal.

Here’s the procedure I’d recommend. You are welcome to show him this post. There is one bonding cement which will bond to metal— Panavia.

The first step will be to grind away more metal to make way for the materials needed. Then, use a micro-etcher to prepare the spot. From there, prime the metal and then add a thin opaque layer of Panavia over the metal and cure it. After that is when your dentist can place the composite.filling.

If that doesn’t work, your best option is to replace the bridge.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.

a Maryland bridge is not a temporary tooth replacement

My daughter had a gymnastics accident which damaged a tooth. Three failed root canal treatments later and we need to extract the tooth. My plan is to eventually replace the tooth with a dental implant when she is old enough. In the meantime, we need a temporary replacement. My dentist suggested a Maryland Bridge. I just wondered what you’d think about that. I asked about a partial flipper, but he said she’d lose them because they’re removable and this will bond to her teeth in the back.

Patricia

Dear Patricia,

First, I want to say your choice of doing a dental implant for her permanent replacement is a fantastic idea. It will serve her very well. I’m glad you realize she will have to wait until her jaw is fully developed. Some parents mistakenly think they can get a dental implant right away, while their child is still a teenager.

dental flipper
Dental Flipper

As for a temporary replacement, your idea is better than your dentist’s suggestion. While a dental flipper is removable and, yes, there is always a chance that your daughter will lose her flipper. In all honesty, though, you could replace several of them for the price of one Maryland Bridge.

With a traditional dental bridge, a false tooth is suspended between two crowns. That requires grinding down the two adjacent teeth, which is definitely not something you’d want to do to healthy tooth structure.

While a Maryland Bridge does not require damaging the adjacent teeth, it is not the temporary tooth replacement your dentist is saying it is.

tooth preparation for a Maryland Brdige
Tooth preparation for a Maryland Bridge

While the Maryland Bridge has two metal “wings” which will bond to the back of the adjacent tooth, without cutting a little groove in the tooth for it to hook into, the bonding is not going to stay. Whenever you are doing any removal of tooth structure, that is not a temporary replacement.

Go with your original idea and get a dental flipper for your daughter.

This blog is brought to you by Lafayette, LA Dentist Dr. Mike Malone.