Aesthetic rehabilitation with Maryland Bridge as a high value alternative to implant therapy. A Case Report

Pio Paraggio

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Modern advancements in dental techniques and the development of more and more mimetic materials consents nowadays to perform esthetic rehabilitations saving most part of the tooth structure and with it preserving the vitality of the tooth. The trend we follow is to realize minimal invasive esthetic restorations that harmonize with the patient’s mouth, ideally replicating the original dental elements with our works. This patient, age 50-year-old, get to our office after a trauma occurred in his worktime that procured a coronal fracture with pulpal exposition of 1.2 and the radicular fracture with subluxation of the element 1.1. The first treatment performed was the extraction of 1.1 and the immediate replacement with an implant (Sweden&Martina Premium), the root canal of 1.2 was treated and a fiber post build up was performed on it. A temporary crown of 1.2 with an extension on 1.1 was placed to get a decent look in the wait for the healing of the surgical procedure. After 4 months it was finally possible to realize a screw retained metal-ceramic crown of 1.1 and a zirconia-feldspatic crown of 1.2. According with the technician we decided to replicate the existing situation of the left incisors to replicate the pre-traumatic situation. A month after we finished the rehabilitation the patient came asking to get a better smile and if possible to correct his crooked frontal teeth. So we asked the technician to realize a wax-up of the possible outcome and we show it to the patient. The final treatment plan is to realize 2 lithium disilicate veneers of 2.1 and 2.2 and to modify the fresh delivered crowns of 1.1 and 1.2 to fit in the new smile project.


Abount the Author

He graduated with honors in Dentistry and Dental Prosthetics at the University of Brescia in October 2009. After graduation, he attended the Prosthesis department under the guidance of Prof. G. Gastaldi as a lover of the subject, giving lessons to the students of the course of Dentistry and Dental Hygiene. In 2012 he obtained the Master's degree in “Prosthetics and Implant-prosthetics with advanced technologies” at the Alma Mater University of Bologna, with a thesis on the digital impression. He attended the annual course of Clinical Periodontology with Dr. G. Polimeni (UCON PHd) and the following year the annual course in Implantology with the same teacher. For 3 years he has followed advanced implantology courses with Dr. N. Barbieri and M. Provisonato (NYU MSC) at health services in Bucharest (RO). In 2017 he attended the semester course in Guided Bone Regeneration with Dr. M. Ronda. Currently he is a freelancer in Brescia and the province, dealing with implantology, prosthesis and general dentistry.