Maryland Bridge

millennium

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Got a set of models to evaluate yesterday. Dr. wants me to prep the lower model to show her prep design for a Maryland bridge #23 - 26 pontics and cainines and first bicuspids prepped for wings. # 20 is missing. I have not talked to the Dr. about the particulars yet. Why a 4 pontic Maryland bridge etc.
My question is (before I post any pictures): If the Dr. insists on a Maryland bridge this size should I decline this case?
Thank you in advance!
 
CatamountRob

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Got a set of models to evaluate yesterday. Dr. wants me to prep the lower model to show her prep design for a Maryland bridge #23 - 26 pontics and cainines and first bicuspids prepped for wings. # 20 is missing. I have not talked to the Dr. about the particulars yet. Why a 4 pontic Maryland bridge etc.
My question is (before I post any pictures): If the Dr. insists on a Maryland bridge this size should I decline this case?
Thank you in advance!
Did she say what material she wants it made from? Any idea how long she expects it to last?
 
millennium

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I would imagine pfm only. I don't think I want this case, but wanted opinions or maybe this or something like this was done by someone here.
If I do the case, I am married to it.
 
CatamountRob

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I would imagine pfm only. I don't think I want this case, but wanted opinions or maybe this or something like this was done by someone here.
If I do the case, I am married to it.
Then say no, it won't last and you'll be doing the patient a favor.
 
rkm rdt

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I would imagine pfm only. I don't think I want this case, but wanted opinions or maybe this or something like this was done by someone here.
If I do the case, I am married to it.
Maybe it's for implants?
 
PRO ARTS DL

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May be doable if the space is not that big?

I would most likely ask the doctor to reconsider or offer different options depending on the purpose/whats expected
 
millennium

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After all is said and done and the Dr. insists on a Maryland bridge for whatever reason, should I except?
If I make this and it fails I am sure the next restoration what ever that may be will be done by me at a substantial discount.
 
Juko

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After all is said and done and the Dr. insists on a Maryland bridge for whatever reason, should I except?
If I make this and it fails I am sure the next restoration what ever that may be will be done by me at a substantial discount.
You lay down your concerns to the doc.
The doc insists, you say that you will do the case but cannot guarantee or warranty the work on this case and when it fails you will not replace for free or at a discount.
Or just decline to accept the case.

You're never married to anything unless you want to be.
 
millennium

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I will call her tomorrow and hear what she says. I don't think I will do the Maryland bridge unless its a temporary fix.
 
CatamountRob

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This guy is just upset that he got caught milking the cow and now he has to buy the cow. He already knows this cow produces terrible milk.
Let's try not to let this thread go down the barnyard animal path, hmm?
 
Tradewindj

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Maryland bridges are a temporary fix, they will fail. Lay out your concerns and explain the terms and take the case $ and do the implants in a few years.
 
JMN

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Got a set of models to evaluate yesterday. Dr. wants me to prep the lower model to show her prep design for a Maryland bridge #23 - 26 pontics and cainines and first bicuspids prepped for wings. # 20 is missing. I have not talked to the Dr. about the particulars yet. Why a 4 pontic Maryland bridge etc.
My question is (before I post any pictures): If the Dr. insists on a Maryland bridge this size should I decline this case?
Thank you in advance!
Not seeing the case, or knowing any patient history it's very easy for me to say no way, but I don't have the relationship to manage or know what stability is there either.

Being lower centrals and laterals, I'd be interested in the bite relationship before making any real judgements. Is canine guidance still functioning? Have they worn everything down to nubs? Are there wear marks in 7-10 from the lowers being ground into them over thousands of cycles?

Generally 23-26 don't receive much force or off long axis torquing motion, unless you have a bruxer, used car dealer, bar brawler, MMA fighter, or beer opener.
 
millennium

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Patient is not a bruxer. There is canine guidance. I guess I should really talk to the Dr. and find out the particulars of the patient.
 
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Don't confuse me with details. My minds made up.

4 pontics with 'wings' to retain. That'll work. :eek::confused:Banghead
 
JMN

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Patient is not a bruxer. There is canine guidance. I guess I should really talk to the Dr. and find out the particulars of the patient.
IF it's intended only as a temporary solution during osceointegration, I'd do it with no further worries from what you've said if the natural lowers didn't leave marks in the uppers..
 
lcmlabforum

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My 2 cents: the first thing that gave me pause -
Dr. wants me to prep the lower model to show her prep design
 
millennium

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Ixney on the Maryland bridge. Patient went for an implant consult. An eight unit bridge is choice #2.
 
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