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Simplicity and Maryland Bridge
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Jul 13, 2005 2:25 pm    Post subject: Simplicity and Maryland Bridge Reply with quote

"Blessed with early onset Altzheimers, my step by step for uncut enamel as in Maryland Bridge bonding is therefore: 1. Clean uncut enamel with alcohol; 2. Dry, Dry, Dry the alcohol with 5-10 seconds with syringe about 2 inches from prep; 3. Dab on Simplicity 1 on enamel and wings of temporary maryland bridge, wait 20 seconds; 4. Gently blow air about 2 sec from about 5 inches away to evenly disperse (not dry) the sim 1; 5. brush on the sim 2; 6. Gently blow excess sim2 about 2 seconds then light cure 20 seconds; 7. Place a brushful of sim2 on the enamel and the metal wings and do NOT cure 8. Place thin film of cement on wing of metal; 9. Press firmly to position; 10. Light cure multiple times from edges of metal (about 40 total for each wing)"

1. SANDBLAST the enamel! Rinse it and DRY for 10 seconds.
2. Apply Simplicity as usual to enamel and light-cure
3. Apply another coat of Sim 2, dry, but DO NOT light-cure
4. Apply a coat of Sim 2 to metal, dry and light-cure
5. Apply another coat of Sim 2 to metal, dry but DO NOT light-cure
6. Add self-cure or dual-cure cement and seat.

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Ekrause



Joined: 11 May 2005
Posts: 782
Location: I'm here now.

PostPosted: Wed Jul 13, 2005 5:45 pm    Post subject: Reply with quote

Better yet, prep the abutments before doing your Maryland bridge. Mine hasn't debonded in 13 years.
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bj



Joined: 15 May 2005
Posts: 320

PostPosted: Wed Jul 13, 2005 9:40 pm    Post subject: Reply with quote

Am I coorrect that in the very 1st post above by John that John's advice is in bold at the bottom of that 1st post & the top unbold is to be ignored?
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Ekrause



Joined: 11 May 2005
Posts: 782
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PostPosted: Wed Jul 13, 2005 10:28 pm    Post subject: Reply with quote

correct
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Lawrie



Joined: 14 May 2005
Posts: 13

PostPosted: Wed Aug 03, 2005 7:23 pm    Post subject: Reply with quote

John,

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

Lawrie
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Ekrause



Joined: 11 May 2005
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PostPosted: Wed Aug 03, 2005 10:07 pm    Post subject: Reply with quote

I bet one abutment is more mobile than the other. In that case, I think you're S.O.O.L!!!
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john kanca



Joined: 14 May 2005
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PostPosted: Wed Aug 03, 2005 10:53 pm    Post subject: Reply with quote

Lawrie wrote:
John,

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

Lawrie


Sandblasting is critical for this metal. Beyond that, I think one must consider full coverage.
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Pcus



Joined: 17 May 2005
Posts: 434
Location: toronto

PostPosted: Fri Aug 05, 2005 7:17 am    Post subject: Reply with quote

I read an article advising to cut small grooves into the incisal/occlusal portion of the metal wings. the result should look like a webbed foot, the cement flows sligthly between these grooves and increases retention. I have tried it a couple of times and it work pretty well. Just use a chamfer shaped diamond and direct it parallel to the wing at a 45 degree angle upwards and this will create a nice groove. remember to sanblast the groove and polish it once it is cemented.
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Lawrie



Joined: 14 May 2005
Posts: 13

PostPosted: Fri Aug 05, 2005 3:56 pm    Post subject: Reply with quote

john kanca wrote:
Lawrie wrote:
John,

I tried this technique to recement a Maryland bridge. The only step I didn't do is sandblast. She came back a few days later with the bridge off. Most of the cement stayed on the tooth but some was on the bridge. Before this effort, it stayed on for six months with Rely X. This bridge is a chronic problem and I've made it twice and done a night guard for her too. Any suggestions?

Lawrie


Sandblasting is critical for this metal. Beyond that, I think one must consider full coverage.


John,

I always sandbast the metal. What I was referring to was not sandblasting the enamel as in the first step of your instruction. I'll try the grooves next time. I've got two patients with recurrent debonding. Neither wants an implant and the abuttment teeth have no restorations so I'm reluctant to recomment a full coverage bridge.

Lawrie
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Kirk Blanchard



Joined: 24 May 2005
Posts: 138
Location: Halifax Canada

PostPosted: Wed Aug 31, 2005 6:01 am    Post subject: Reply with quote

1. SANDBLAST the enamel! Rinse it and DRY for 10 seconds.
2. Apply Simplicity as usual to enamel and light-cure
3. Apply another coat of Sim 2, dry, but DO NOT light-cure
4. Apply a coat of Sim 2 to metal, dry and light-cure
5. Apply another coat of Sim 2 to metal, dry but DO NOT light-cure
6. Add self-cure or dual-cure cement and seat.


I have a maryland bridge delivery this morning. In my tool kit, I have Panavia, Nexxus and Variolink II.

I had planned on Panavia. Given my options, is that the best choice? Are there any technique modifications required for the Simplicity + Panavia combo?[/b]
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Mark J Fleming DDS



Joined: 11 May 2005
Posts: 736
Location: Sarasota, FL

PostPosted: Wed Aug 31, 2005 6:50 am    Post subject: Reply with quote

Kirk,

I would use Panavia as the dual cure with no modifications. Is the metal base metal (nonprecious)? Cool
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Kirk Blanchard



Joined: 24 May 2005
Posts: 138
Location: Halifax Canada

PostPosted: Wed Aug 31, 2005 6:56 am    Post subject: Reply with quote

Indeed
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Aug 31, 2005 7:15 am    Post subject: Reply with quote

I agree- that would be my choice of the cements you have.
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Kirk Blanchard



Joined: 24 May 2005
Posts: 138
Location: Halifax Canada

PostPosted: Wed Aug 31, 2005 10:07 am    Post subject: Reply with quote

Thank's everyone. The appointment went beautifully.

As an aside, the impression was made with Howard G's trayless impression. The margins were goreous.

I used Simplicity plus Panavia. Clean up was a breeze and the procedure went very smoothly.

I'm afraid to think of the days before I found internet support, and equally afraid to think of what else I will learn that could improve my present techniques.
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Mark J Fleming DDS



Joined: 11 May 2005
Posts: 736
Location: Sarasota, FL

PostPosted: Wed Aug 31, 2005 10:19 am    Post subject: Reply with quote

Kirk Blanchard wrote:
Thank's everyone. The appointment went beautifully.

As an aside, the impression was made with Howard G's trayless impression. The margins were goreous.

I used Simplicity plus Panavia. Clean up was a breeze and the procedure went very smoothly.

I'm afraid to think of the days before I found internet support, and equally afraid to think of what else I will learn that could improve my present techniques.


Kirk,

Don't be afraid, be excited about ALL the new things you can do. I 've seen a few new things since '78. I agree about having these boards, nice info. Cool
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