ArticlePDF Available

The Origin of the Maryland Bridge

Authors:
James Leo Gutmann at Texas A&M University College of Dentistry
James Leo Gutmann
  • Texas A&M University College of Dentistry
Download full-text PDF
Read full-text
Download citation

Abstract

The dental world was introduced to a revolutionary and esthetically pleasing adhesive-retained fixed partial denture for the replacement of anterior missing teeth in the early 1980s.1, 2 Patient comfort was enhanced along with minimal pulpal trauma to adjacent teeth that may occur with the extensive cutting of tooth structure with the use of full coverage crowns. Proffered by faculty from the University of Maryland, this tooth replacement was ultimate known as the Maryland Bridge, and it has been used extensively to the benefit of many patients. However, as with anything in history, especially the history of dentistry, the evolution of these types of improvements often comes from information buried in the vaults of the numerous dental publications that arose in the 1700-1800s, vaults that are only too often never opened to the riches within. So it was also with this prosthetic replacement as significant evidence exists in 1887 that this prostheses was used routinely by restorative dentists.3 Dr. Allison R. Lawshee from Trenton, NJ, USA provided the dental world with this replacement prosthesis almost 100 years prior to the what we know today at the Maryland Bridge. While not possessing the properties of contemporary etching and adhesion, minimal tooth damage was highlighted and sound principles of cementation were advocated Figs. 1, 2 and 3. Historical evidence and enlightenment for today's generation at its finest.
Content uploaded by James Leo Gutmann
Author content
All content in this area was uploaded by James Leo Gutmann on May 10, 2020
Content may be subject to copyright.
110 Journal of the History of Dentistry • Vol. 67, No. 2 • Fall 2019
The dental world was introduced to a
revolutionary and esthetically pleasing adhesive-
retained xed partial denture for the replacement of
anterior missing teeth in the early 1980s.1,2 Patient
comfort was enhanced along with minimal pulpal
trauma to adjacent teeth that may occur with the
extensive cutting of tooth structure with the use of
full coverage crowns. Proered by faculty from the
University of Maryland, this tooth replacement was
ultimate known as the Maryland Bridge, and it has
been used extensively to the benet of many patients.
However, as with anything in history, especially the
history of dentistry, the evolution of these types of
improvements oen comes from information buried
in the vaults of the numerous dental publications that
arose in the 1700–1800s, vaults that are only too oen
never opened to the riches within. So it was also with
this prosthetic replacement as signicant evidence
exists in 1887 that this prostheses was used routinely
by restorative dentists.3 Dr. Allison R. Lawshee from
Trenton, NJ, USA provided the dental world with
this replacement prosthesis almost 100 years prior
to the what we know today at the Maryland Bridge.
While not possessing the properties of contemporary
etching and adhesion, minimal tooth damage was
highlighted and sound principles of cementation were
advocated Figs. 1, 2 and 3. Historical evidence and
enlightenment for today’s generation at its nest.
1. Livaditis GJ, ompson VP. e Maryland bridge
technique. TIC 1982;41(11):7-10.
2. Livaditis GJ. Etched metal resin-bonded
restorations: principles in retainer design. Int J
Periodontic Restorative Dent 1983;3(4):34-47.
3. Lawshe AR. A system of removable bridge
substitution, using sound teeth, cavities and roots
as abutments. Dent Items Int 1887;19:661-667.
The Origin of the Maryland Bridge
James L. Gutmann, DDS, Cert Endo, PhD,
FACD, FICD, FADI, FAAHD,
FDSRCSEd, Diplomate ABE, Professor Emeritus
Texas A&M University College of Dentistry
Dallas, Texas
Correspondence:
Dr. James L. Gutmann
3212 Basil Court
Dallas, Texas 75204-5543
+1-214-449-4424
Email: jlg@histden.org
Figure 1
Figure 2
Figure 3
... This statement is entirely consistent with a Guttman and Ghimire which support the importance of patient comfort while undergo this treatment. [13], [14] Despite the limitation of retrospective data regarding this patient's intra and extra oral condition soon after the accident, anterior tooth loss demands prompt attention due to function and appearance. In general, missing single teeth can be treated with various treatment options like reimplantation, removable partial denture, or fixed dentures. ...
... [19] Resin-bonded bridges were introduced as an alternative to traditional fixed partial dentures by Livaditis for the replacement of anterior missing teeth since in the early 1980s. [13] Therefore, Maryland bridge was used as treatment option in this patient since it is minimal invasive and conservative to tooth tissue, minimizing pulpal trauma with pain-free procedure compared to other alternative dental procedures. [13], [14] Local anaesthesia is often not required, leaving the children at comfort of undergoing the dental treatment during teeth preparation of the Maryland bridge. ...
... [13] Therefore, Maryland bridge was used as treatment option in this patient since it is minimal invasive and conservative to tooth tissue, minimizing pulpal trauma with pain-free procedure compared to other alternative dental procedures. [13], [14] Local anaesthesia is often not required, leaving the children at comfort of undergoing the dental treatment during teeth preparation of the Maryland bridge. Other benefits include less periodontal irritation results compared with the conventional bridge. ...
High Patient’s Acceptance of Maryland Bridge: A Minimal Procedure Following Dental Trauma
Article
Full-text available
  • Jan 2023
Traumatic dental injuries are more prevalent in permanent than primary dentition, in which maxillary incisors are more affected. The global prevalence of traumatic tooth injuries ranges from 6 to 37%. According to one study, out of 1,657 schoolchildren (aged 5-8 years) surveyed, 2.7% had traumatic injuries to their anterior teeth. A completely knocked-out front tooth often occurs as a result of a traumatic dental injury, which produces psychological and functional distress for the patient and should be treated immediately. There are various treatment options such as reimplantation, removable partial dentures, or fixed dentures, which are often not applicable or inconvenient for the patient, especially in young patients where bone growth is ongoing. Therefore, a resin-bonded fixed partial denture such as Maryland bridge is a treatment option for young patients who needed a replacement for missing anterior teeth before their growth and development was fully complete.
View
... The world of dentistry was introduced to a revolutionary and aesthetically pleasing adhesiveretained fixed partial denture for the replacement of previous missing teeth. (Gutman JL, 2019) [10] In the 1980s and 1990s, improvements in preparation methods, metal alloys, and bonding techniques made adhesive bridging a more predictable option. (Wyatt CC, 2007) [32] . ...
... It can be used as a permanent and intermediate prosthesis when planning implants and fixed partial dentures. (Gutman JL, 2019) [10] . ...
View
... Over the last 10 years reviewed by this study, the term Maryland bridge was employed in the title of a historical article (Gutmann et al., 2019 [80]) and in the abstract of a second as a treatment option that is not aesthetic (Moslehifard et al., 2014 [104]). ...
Terminology focused on design and retention methods used for anterior resin-bonded fixed partial dentures in English literature: A scoping review
Article
Full-text available
  • Nov 2023
Purpose Novel terms describing several designs of resin-bonded fixed partial dentures (RBFPDs) continue to appear. Indeed, a variety of terms are used in the English scientific literature The use of a standard terminology is important for a fair and efficient understanding. This study aimed to investigate if the terminology used to describe designs and retention methods for anterior RBFPDs is standard. Methods An electronic search in the English literature was conducted in PubMed/Medline to identify all publications reporting RBFPDs in the anterior region until August 2022. This search was completed by hand searching. Terms indicating different designs of RBFPDs were listed and then classified. Percentages of their use were calculated to determine the commonly used terms. Analysis of the use of these terms was performed based on the standards determined by the latest edition of the Glossary of Prosthodontic Terms (GPT). The impacts of the MeSH Thesaurus and GPT on the nomenclature used for RBFPDs was assessed. Results A total of 125 articles were eligible for this review. In the retained articles, 86 terms were found. Among them, thirty-nine terms were classified into three groups. Only six terms were defined in the latest edition of GPT (GPT-9). Several classified terms that are commonly used were not identified in the GPT-9. Conversely to the GPT-9 which impact was insignificant, the MeSH Thesaurus had an important impact on the nomenclature used for RBFPDs. Conclusion The terminology used to describe designs and retention methods for anterior RBFPDs was non-standard. The GPT-9, constituting an important reference, defined a limited number of terms related to RBFPDs and had no significant impact on the standardization of the terminology used for RBFPDs. Efforts should therefore be continued to standardize the terminology. A specialized mini-glossary grouping and defining all the terms found in this study will helpful in clarifying the terminology used for the anterior RBFPDs.
View
... Over the last 10 years reviewed by this study, the term Maryland bridge was employed in the title of a historical article (Gutmann et al., 2019 [80]) and in the abstract of a second as a treatment option that is not aesthetic (Moslehifard et al., 2014 [104]). ...
View
... It can be used as a permanent as well as an intermediate prosthesis while planning for implants and fixed partial denture. [1] RBBs have micromechanical bonding with the tooth surface and the metal alloy surface and it requires minimal or no tooth reduction. Various types of RBBs are Rochette bridge, Virginia bridge, and Maryland bridge, among which Maryland bridge is commonly used. ...
Resin-bonded bridge as a simplified approach to restore missing teeth in esthetic zone by conventional and digital techniques
Article
Full-text available
  • Dec 2022
  • Dent Res J (Isfahan)
One of the most challenging esthetic concerns in dentistry is conservative replacement of the missing anterior teeth. Although implants are considered to be a better treatment option for rehabilitation of such patients, resin-bonded bridges (RBBs) can conservatively restore the missing teeth and have thus gained popularity over the years. It consists of an artificial tooth with a wing-like extension that is cemented to the adjacent teeth. There are various types of RBBs among which Maryland bridge is the simplest and the popular most due to its micromechanical retention enabled by acid etching of both tooth and metal retainer. It can be fabricated by various techniques and materials. In this case reports, we have discussed about two unique designs of Maryland bridge fabricated by two different materials (Porcelain-fused metal and Graphene) and utilizing two different techniques (conventional and digital).
View
... RBFDPs began to be known in the world of dentistry in the 1970s [8] and their design evolved over time [6]. Within this group, we can mention the Maryland bridge, [6] which was created by professors from the university of the same name [9] and its main characteristic is to have two palatal retainers; There is also the cantilever, whose peculiarity is based on the possession of a single palatal retainer [6]. Currently, they are used to replace missing teeth in the anterior sector [10]; however, at some point an attempt was made to extend their indication to the posterior sector [11], but several investigations have shown unfavorable results [12]. ...
View
ResearchGate has not been able to resolve any references for this publication.