Maryland Bridge (Resin Bonded Retainer)
The main advantage of a Maryland Bridge is that it preserves most of the tooth enamel. The treatment time is less, reducing the cost to about half. More importantly, it is cost effective, especially if the procedure lasts for long periods of time or longer than other treatments would have lasted. There is less chairside time required and usually no anesthesia is needed. If anesthesia is needed, it is usually for the developing of a soft tissue pontic receiving site on the edentulous ridge or removal of lesions from previously failed attempts of tooth restoration. Additionally, it is a reversible technique. This reduction intra-oral and laboratory procedures equates into savings for the patient. Livaditis and Thompson, 1982, estimated that fees for the Maryland Bridge are 50-60% less than conventional crown and bridge fees. An esthetic advantage is that only the lingual (tongue side) surfaces of anterior teeth are covered, and therefore no metal from the retainers show.
The disadvantage to a Maryland Bridge is that it is extremely technique sensitive. For example, if sloppy bonding procedures allow water or oral secretions to mix in with the luting resin, it can destroy the bond. With all new procedures, long-term studies are rare and familiarity with the technique is still a learning process. Other disadvantages are that it can't be used for unhealthy or broken down teeth and the metal retainers may show through thin anterior maxillary teeth causing a graying problem.