Dear Dentist,Recently my dentist have placed a Maryland bridge, and in the final of the work, the one of the wings, supported by my front teeth, was to long, making dark the trans lucid area of the teeth. So the solution that my dentist found was to cut the wing in the place. He used a hi speed drill, and part of the wing were removed? The gap in the back of the teeth, once that now the wing is short, was felled with a withe cement.During the procedure of cutting was not used anesthesia, and I had no pain, so I hope that he did not touch the teeth with the drill.My question is : Is this procedure/work correct? and what risks can it has for me in the present and in the future. Should I present a complain, or everything is ok?
Person's Gender: Male
Person's Age: 30
Welcome to Justanswer.I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.I live in Maryland in the US where the Maryland bridge was invented.Most dentists do not use this technique much anymore because it is usually just a matter of time before they fall out .Leakage occurrs between the wing bond and the tooth and these bridges cannot just be cemented back on..they need to go back to the lab and be reetched and then you are left with a missing tooth for days.There is no great mechanical retention with these bridges and although they were used for a while..they are pretty much obsolete.Your teeth are probably fine,the lab probably made the wing too long which makes me suspect that the quality of the lab may not be so good.These bridges are cheaper,but the life span is shorter.They also have a tendency to make the abutment teeth look gray or dark.You need to be careful with them because the shear forces on them is what causes them to dislodge.The gap where the cement was placed is going to be the weak point because no cement that is exposed in the mouth will be stable over time.If you have any further questions please ask.
Dear Dr. Katz,Thank you for your answer, was very clear.I just have still a doubt. The procedure of cutting the wing in the place, (already on the teeth) was safe? I mean, is possible to do it without damage the teeth that support the wing? As told you I did not felt pain during the cuting, but for me was strange cutting such a hard metal in the teeth. Thank you very much once again.
The cutting of metal while the bridge is in place could certainly create some heat that could damage the pulp of the tooth.Hopefully it was cut using lots of water to cool the tooth and the metal down in the process.My concern is that the metal wing is supposed to be customized to that tooth,and because there was an overextention,the edge of that metal is not covering the tooth portion that was prepped specifically to accept that metal,thereby leaving an open cement line which can deteriorate.If the heat generated were high enough..you would have probably felt some pain.
Dentist and Anesthesiologist for 33 years
Thank very much once again. I just need to check also the metal composition of wings, I do not know of what are made.If im not abusing, I should just make you a last question. The wing as we know, was cuted, so now the metal surface, is less polished and more exposed. Do you think that it can be more toxic because of that? Maybe allowing more corrosion of the alloy? should I have a special care about that? Im really concerned about all this.thank you very much once again.
The integrity of the alloy should not be compromised..it is solid and designed not to corrode..it's the margin between the tooth and the metal where the cement is exposed that is the weak point.No cement should be exposed in your mouth.
Dr. Katz,Thank you very much for your help. I think that I can conclude that I had bad luck. Now I will need to manage this the best way, specially about what you stress, the cement in the back of the teeth. I will try to keep the integrity of this "supporting" teeth that so far is very healthy and clean.Kind regards XXX XXXXXX once again.
Good luck,just be careful putting alot of pressure on the artificial tooth..it is only cement holding it on.