1 wing Maryland Bridge
Thanks Everyone for sharing your thoughts and ideas on how to do one wing maryland bridges - here is a case I did based on your reccomendations - its been in the mouth 4 months now and she loves it!
One thing I would have changed if I were to do it over is to use the laser and hollow out the gingiva so the neck of the pontic would be thicker porcelain and wouldn't show the pink gingiva through the porcelain so much.
Love Cerecdoctors.com for helping me explore options I hadnt thought of before!
Greg
Looks great Greg. Just curious, what was the reason you put the wing on the central and not the canine. I am assuming occlusal issues.
Pete
That's a cool restoration! I gave up on maryland bridges years ago. After getting CEREC I'm all excited about this kind of minimally invasive solution.
On 10/26/2015 at 2:41 pm, Pete Becher said...Looks great Greg. Just curious, what was the reason you put the wing on the central and not the canine. I am assuming occlusal issues.
Pete
Great question - 2 reasons
1) The loss of gum tissue (Recession) was greater on the distal of the central - in my mind that meant the connection between the wing and the pontic could be a little larger - It made sence to me that the larger the connection the longer it should last.
2) The lingual of both the Canine abd the Central already had been prepped for an old PFM maryland bridge she had years ago, but the central was prepped more agressivly, so I choose the one that was ugliest.
THIS CASE LOOKS GREAT!!
acouple things to note:
An LT block will create less show through of the gingival color behind your pontic, if you didn't already use an LT. There are other bloc
Using a laser to create a divot in the tissue can create better emergeance profile and more importantly add thickness to the base of the pontic, making it less translucent.
some opaque staining in pink or white on the lingual of the pontic could also help to mask that color coming through.
Sorry I cant find a smile shot after but this is what it would be like for her based on her before...
Greg thats awesome. Love 1 winged maryland bridges, great service for the patient! With the new MT shades of emax I think this will be an even easier esthetic solution in the future
Great post! This was the first thing I started doing when I got my Cerec. It was amazing 3 cases all at once. Love it, love it. Your case is outstanding wish I took pictures but too new at the time. What great docs we are! Cerecdocs!
Carrie
Nothing but nice Greg..... tissue contouring great as you suggest, not only for the issue here. or to be sure adaptaion is optimal. I have at time added dentinal porcelain to these areas, not so much to block out, but to create more ovate form where either soft tissue contouring or model editing didn't get it done.
On 10/27/2015 at 10:27 am, Robert Rioseco said...THIS CASE LOOKS GREAT!!
acouple things to note:
An LT block will create less show through of the gingival color behind your pontic, if you didn't already use an LT. There are other bloc
Yes I Used LT on this case
Using a laser to create a divot in the tissue can create better emergeance profile and more importantly add thickness to the base of the pontic, making it less translucent.
Agreed
some opaque staining in pink or white on the lingual of the pontic could also help to mask that color coming through.
Do you have any photos of this technique you could share?
