A Maryland bridge, also called a resin-bonded or adhesive bridge, replaces a missing tooth with an artificial tooth held in place by thin "wings" bonded to the backs of the neighboring teeth. Little or no drilling is involved, and no crowns are placed on the healthy teeth beside the gap. It works best for a single missing tooth with sound teeth on either side. It is not right for every mouth, and the details of your bite matter a great deal.
Below, we explain how the design works, what the research says about lifespan, how it compares with a traditional bridge and an implant, and how to decide whether it deserves a place on your shortlist.
TL;DR
- A Maryland bridge bonds a replacement tooth to the back surfaces of the adjacent teeth, so those teeth keep most of their natural structure.
- A 2017 systematic review (opens in a new window) estimated survival of 91.4% at 5 years and 82.9% at 10 years. Debonding (the wing coming loose) is the most common problem.
- It suits small gaps bounded by healthy teeth, and it is often used as a bridge to a later implant in teens whose jaws are still growing.
- Heavy bite forces, grinding, or a gap of more than one tooth make a traditional bridge or an implant the stronger choice.
- Only an exam and X-rays can tell you which option fits. We are happy to walk you through them.
Table of Contents
- What a Maryland bridge is
- How the procedure usually goes
- How long does a Maryland bridge last?
- Maryland bridge vs. traditional bridge
- Maryland bridge vs. dental implant
- A bridge for a growing jaw
- Who is a good candidate
- Caring for a Maryland bridge
- Our perspective
- Replacing a missing tooth in Piedmont
- Questions people ask about Maryland bridges
- Sources
What a Maryland bridge is
The American Dental Association's glossary defines a Maryland bridge as a resin-bonded fixed partial denture with wing-like retainers bonded to abutment teeth (opens in a new window). Break that into plain parts:
- The pontic is the false tooth that fills the space. It is usually porcelain or a tooth-colored ceramic.
- The wings are thin extensions of metal or ceramic that fold behind the pontic.
- The abutment teeth are the natural teeth on either side of the gap. The wings are bonded to the back (tongue side) of these teeth with a strong dental resin cement.
The name comes from the place it was developed. According to the Journal of the American Dental Association (opens in a new window), researchers at the University of Maryland Dental School created the resin-bonded prosthesis in 1980.
Think of the neighboring teeth as the supports of a footbridge. In a traditional bridge, we wrap each support in a crown. In a Maryland bridge, we attach the span to the back of the supports and leave the visible front surfaces untouched.
How the procedure usually goes
Every case is different, but a Maryland bridge generally follows these steps.
- Consultation and exam. We look at the gap, the health of the neighboring teeth, the thickness of the enamel on their back surfaces, and how your upper and lower teeth meet.
- Planning your shade and shape. The replacement tooth should look like it belongs in the overall composition of your smile, with the right color, translucency and proportion.
- Light preparation. The clinical literature describes these bridges as typically requiring no anesthesia and minimal tooth reduction (opens in a new window), often less than half of what a full crown needs. Some cases need tiny guide grooves or none at all.
- Impressions. The bridge is made to fit the back of your teeth precisely. The same article notes that the margins sit above the gumline, which makes impressions easier and more comfortable.
- Bonding. Once the bridge is fabricated, it is bonded with resin cement. Careful isolation and a meticulous cementation routine are central to success.
- Bite check and follow-up. We adjust how the teeth meet so the bridge is not taking unnecessary force.
Because preparation is so gentle, many patients who feel anxious about dental work find this a calmer experience than a traditional bridge or implant surgery. That said, we will always tell you plainly if your mouth points toward a different option.
How long does a Maryland bridge last?
This is the question most people ask, and the honest answer is a range, not a single number.
The 2017 systematic review in the Journal of Prosthetic Dentistry (opens in a new window) pooled studies of resin-bonded bridges followed for at least five years. Its estimates were:
| Time in service | Estimated survival |
|---|---|
| 5 years | 91.4% |
| 10 years | 82.9% |
The most frequent technical complication was debonding, which occurred in roughly 15% of cases within the first five years. The review also found that bridges built on a zirconia framework and retained by a single tooth (a "cantilever" design) performed better.
What survival really means
Survival does not mean the bridge never needed attention. A bridge that comes loose and is rebonded still counts as having survived. Clinicians commonly note that rebonding or rebuilding the framework after a dislodgement is a standard procedure (opens in a new window) that can extend the life of the restoration significantly.
So plan on this: a Maryland bridge can serve you well for many years, but you may need a rebond visit along the way. If you want the longest-lasting, set-it-and-forget-it solution, an implant is generally the stronger candidate, and we say so openly.
Why one wing can beat two
It sounds backwards, but the same review reported that bridges retained by only one tooth had a statistically significantly higher survival rate and fewer debonds than those retained by two or more. The likely explanation is that teeth move very slightly and independently when you chew. A bridge fixed rigidly to two teeth can put stress on the cement, while a single-wing design lets each tooth move on its own. Whether a single-wing design is appropriate for you depends on the location of the gap and your bite, which is a judgment made at the chair.
Maryland bridge vs. traditional bridge
The central difference is what happens to the neighboring teeth. The ADA's MouthHealthy page on bridges (opens in a new window) describes a bridge as an appliance that replaces missing teeth with artificial ones, anchored to adjacent teeth. How it is anchored changes the tradeoffs.
| Maryland bridge | Traditional bridge | |
|---|---|---|
| Attachment | Wings bonded to the back of neighboring teeth | Crowns placed over the neighboring teeth |
| Tooth reduction | Minimal or none | Significant, on both neighbors |
| Anesthesia | Often not needed | Usually needed |
| Best for | One missing tooth, healthy neighbors, lighter bite forces | Larger spans, back teeth, teeth that already need crowns |
| Typical weak point | Debonding of the wing | Decay under the crowns, loss of tooth structure |
| Reversibility | Largely conservative; options stay open | Prepared teeth need crowns for life |
If the teeth next to your gap are already heavily filled or cracked, a traditional bridge may actually make more sense. Those teeth need crowns anyway, and the crowns give the bridge a stronger foundation. If those teeth are healthy and unrestored, preserving them is a persuasive reason to try a Maryland bridge first.
Our published fee for a fixed three-unit bridge is $3,000 to $4,500, per bridge. Fees for other treatments depend on your exam, so we quote them after we see you.
Maryland bridge vs. dental implant
The ADA lists implants and removable partial dentures (opens in a new window) alongside bridges as the main ways to replace a missing tooth. An implant works as a synthetic root placed in the jawbone, topped with a crown, so it does not rely on neighboring teeth at all.
Where a Maryland bridge makes sense over an implant:
- You prefer to avoid surgery or have a medical reason to delay it.
- There is not enough bone, and grafting is not something you want right now.
- You are a teenager or young adult whose jaw is still developing.
- You want a lower upfront investment and are comfortable with the possibility of a rebond.
Where an implant is usually the better answer:
- You want the most durable long-term replacement.
- You grind your teeth or have a deep bite that would stress a bonded wing.
- The gap is in a heavily loaded back-tooth area.
- You do not want to depend on the neighboring teeth at all.
We place and restore implants, and our published fee is $4,000 to $6,000 per single tooth. You can read more on our page about dental implants in Piedmont, CA. Neither option is right for everyone, and the goal of the exam is to match the option to your mouth rather than the other way around.
A bridge for a growing jaw
One of the best uses for a Maryland bridge is in adolescents. A published paper on Maryland bridges as an interim prosthesis in adolescents (opens in a new window) explains that implants and traditional bridges can interfere with jaw development or require removing too much healthy tooth, so a Maryland bridge allows esthetic tooth replacement while growth continues.
For parents, this matters. A teenager who loses a front tooth to sports or a congenital absence does not have to walk around with a gap for years. A conservative bridge can restore the smile now, and an implant can be considered later once growth is complete.
Who is a good candidate
Based on the clinical literature, the Maryland bridge is highly effective for small gaps bounded by sound teeth (opens in a new window), and success depends on careful case selection. These are the questions we ask.
- Is there one missing tooth, or a short span? Longer spans put more load on the wings.
- Are the neighboring teeth healthy? Large fillings, cracks or thin enamel on the back surfaces reduce the bonding area.
- How do your teeth meet? A deep overbite, or a habit of grinding or clenching, can load the wing in the wrong direction.
- Where is the gap? Front teeth see lighter forces than molars, which is why these bridges are so often used for incisors.
- Are your gums healthy? Any bridge or implant depends on healthy remaining teeth and bone, and the ADA stresses regular professional oral hygiene and exams (opens in a new window). If gum disease is present, we treat it first, and our periodontal team can help.
If you grind your teeth at night, tell us. A custom night guard can protect any restoration, and it may change which option we recommend.
Caring for a Maryland bridge
A bonded bridge is only as secure as the teeth and gums under it. A few habits make a real difference:
- Brush twice daily and clean under the pontic every day with floss threaders, a floss that can slide beneath the false tooth, or a water flosser. Our guide on how to brush and floss properly covers the technique.
- Avoid biting hard objects such as ice, pen caps or hard candy with the bridge, and avoid tearing food with the replaced front tooth.
- Keep your regular cleanings and exams so we can check the bond and the margins.
- Call us if the bridge feels loose or the wing lifts. Do not try to glue it back yourself, since household adhesives can damage the tooth surface and make a proper rebond harder.
Our perspective
We have cared for families in Piedmont and the East Bay since 1996, and the question we hear most often about a missing tooth is, "What is the least I have to do to my healthy teeth?" That is a good question, and the Maryland bridge is one honest answer to it.
We think the right replacement is the one that fits your bite, your health, your age and your goals, not the one that is easiest to sell. For a young patient with a single front-tooth gap and healthy neighbors, a conservative approach can be wonderful. For an adult who wants a replacement that stands alone and may last decades, we often steer toward an implant. For a gap flanked by teeth that already need crowns, a traditional bridge can be the most sensible choice.
Whatever we recommend, we explain it step by step, show you the options, and leave the decision with you. A comfortable visit and clear answers matter as much as the restoration itself.
— Dr. Martenson & Dr. Ma
Replacing a missing tooth in Piedmont
If you are weighing your options, our restorative dentistry page lists the bridge, crown, filling and implant services we offer, with published fees where available. Book an exam and we will look at the gap, your neighboring teeth and your bite, then explain which replacement fits. You can also see results on our dental implant smile gallery and learn about crowns if your neighboring teeth need reinforcement.
Questions people ask about Maryland bridges
Does a Maryland bridge hurt to place?
Usually very little. Because the preparation is minimal, the clinical literature notes that these bridges generally need no anesthesia (opens in a new window). Some patients feel mild sensitivity for a short time afterward. If you feel anxious, tell us and we will adapt the visit.
Can a Maryland bridge replace a back tooth?
It is possible in selected cases, but back teeth take far heavier chewing forces, which raises the risk of debonding. Most clinicians favor front teeth for this design. For a molar, we more often discuss an implant or a traditional bridge.
Is a Maryland bridge permanent?
It is fixed, meaning you do not remove it, but it is not guaranteed for life. The pooled estimate (opens in a new window) was 82.9% survival at 10 years. Many patients use it as a long-term solution, and others as a stepping stone to an implant.
What if my Maryland bridge comes loose?
Contact us promptly and keep the bridge safe. Debonding is the most common complication, and a loose bridge can often be cleaned and rebonded. Waiting risks decay on the exposed tooth surface or damage to the bridge.
Is a Maryland bridge the same as a resin-bonded bridge?
Yes. Maryland bridge, resin-bonded bridge and adhesive bridge all describe the same type of restoration: a replacement tooth held in place with wings bonded to neighboring teeth.
Sources
- ADA Glossary of Dental Terms (opens in a new window)
- Systematic review of survival and complication rates of resin-bonded fixed dental prostheses (PubMed) (opens in a new window)
- Maryland Bridge: An Interim Prosthesis for Tooth Replacement in Adolescents (PMC) (opens in a new window)
- Maryland Bridge Passes the Test of Time (JADA) (opens in a new window)
- Bridges, MouthHealthy (ADA) (opens in a new window)
- Missing Teeth, MouthHealthy (ADA) (opens in a new window)
