Emax Maryland bridge

[TheLabGuy]

I'd probably do Zirconia on this, make the lingual all-zirconia (no layering porcelain) because of the deep bite. What you can do to get this to etch better is during your glazing, apply a thin layer of glaze on the intaglio surface of those wings. A thin layer won't affect the fit and allow the zirconia to be etched properly so the Dentist can bond to it. Not enough room for E.max IMO and an Implant would be the ideal situation here.

 

[amadent]

IMO and an Implant would be the ideal situation here.

you got that right- thanks for the advice Rob

 

[AL1]

I first posted this thread 03-05-2010. I haven't heard that it failed and the doc is still an account.

 

[user name]

I had posted earlier in this thread about my 100% success with e.max marylands. No longer. One has failed, so unless its a little 'Barbie' type with no signs of brux or biting fingernails, theyre going to be lavas.

 

[rkm rdt]

The biggest mistake is to design the "wings " as if they were metal wings.

You need to design the connectors more like inlay preps than wings.You want to create a cingulum ledge from the axial walls towards the lingual with rounded internal line angles.
Design around contact points if possible or prep for material thickness at least.

Dr should prep axial walls lingual to contact points of abutment teeth to improve connector thickness and path of insertion.

You need to create a prep guide for the Dr on these cases.

Lithium Disilicate is the ideal mat'l for this technique.I have made about 50 this way.

Tooth mobility is the biggest concern here obviously. Debonding is an indication that perhaps an implant is preferred.

 

[paulg100]

For those recommending using glaze on the wings for etching, are you absolutely sure that glaze etches properly?

I'm sure i read somewhere that it doesn't which is why i use a ceramic slurry, not glaze.

 

[cosmicsport]

Hi,
I did one. but they will break.
Better solution : Zirconia framework and overpress with Zirpress (LT or HT)
Do a incisal cutback and layer.

 

[sksaville]

Hi Jeff, I am a dentist getting ready to cut the preps for my first emax maryland bridge. When you say 1 wing, do you mean like a cantilever? So if 7 is missing, cut the prep on either 6 or 8 and only bond to one tooth?
Suzanne

 

[sksaville]

rkm rdt

I am a dentist getting ready to cut my first prep for emax maryland bridge. I have always done the traditional metal wings. I downloaded the preps from a dental lab and they are similar to what you describe. I am wondering what the others are referring to when they mean one wing vs. two wings? Do they mean like a cantilever? What are your thoughts on that?
Suzanne

 

[CatamountRob]

Aren't Maryland bridges still a contraindication for e.max?
You can cantalever a lateral off a cuspid, but last I knew that was it.

 

[ed 3]

I done it many times, you have to sprue it only on the pontic aria, right on the tip aria

 

[Gru]

I've done many emax maryland bridges for my clients, most with great success. Beware even slightly mobile abutment teeth though. I'm redoing my first in years right now. Keep them completely out of occlusion & don't ever do them on mobile teeth or you will be redoing them!

 

[user name]

Hi sksaville. I had an early post on this thread saying I had done some...all 2 wingers. I was in error to the context of the original posts. Mine have all been 1 wing per side. Youre getting ready to do one? Dont. I wish I hadnt done any, although theyre still in the mouth, minus one. Implant or flipper. If you insist, dont do it as a maryland. Deep preps that extend interprox. No part of the restoration should be less than 1mm and everything should thicken towards the pontic. E.max is awesome, but its not a magic bullet.

 

[TheLabGuy]

If you do e.max, think of it as a temporary. I've done a ton of them as a cantilever, with one wing, with two wings...and a lot of them are still in place today. However, there is some that aren't, and have gone to metal/implant or resin. I'd say probably 30% fail rate in the last 6 years when it comes to using e.max in those situations, that's too high for my customers/patients.

 

[sksaville]

Thanks for the input. Yes, I did not do Maryland bridges for years because of the failures I have seen. But this case cannot have implants because the root tips of centrals and cuspids point toward the laterals and he does not have enough room for implant. Patient had ortho as a kid but is slightly Class III (underbite) and just does not have enough premaxilla bone for implants. Good news is the anterior teeth have slight open bite so there is no question of room for occlusion. Patient has worn retainer/flipper for 15 years. Now he would like something more permanent. I have told him at least with MB or emax he can still go to traditional bridge if/when they fail. Add to that he is active duty and on a ship so is at sea for months at a time.

 

[dhdc]

This is one i did about 3 months ago,one wing and a fat connector,fingers crossed!!