97 year old patient presented with pain on #24.
Tooth was fractured close to the apex.
We discussed all options including an implant (patient was not interested due to finances and age), fixed 3 unit bridge ( was not really an option as one of the adjacent tooth was already an abutment to another bridge and we didn’t want to remove that bridge ), partial or stayplate ( Pt did not want a removable option).
The best and most conservative option was to do a Maryland Bridge ( One wing ). When you do 1 wing the sprue can be placed on the pontic. When you do 2 wings the sprue will always end up on the edge of the wing .
Tooth was removed . Apical portion was intentionally left behind as it was Endo treated and would have caused more trauma given the patient’s age and on blood thinners. Scanned and designed for Maryland bridge. Emax used for the final restoration.
The tissue closed quickly after extraction as there was minimal trauma to the area. The Maryland Bridge design, milling and oven time took about an hour and it was bonded after crystallization. The patient was super happy as he didn’t want to be without a tooth and no other option was a practical one.
Have you tried making Maryland Bridges with CEREC ? If you haven’t you must. It can be a great option in selective cases. If you have any questions feel free to reach out to me .
Keep CADCAMing.