Dual-Wing Zirconia Maryland Bridge: A Real Solution for Anterior Tooth Replacement

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Replacement of a missing anterior tooth represents a clinical challenge due to functional, esthetic and psychological considerations. Although implant-supported restorations are commonly regarded as the treatment of choice, clinical limitations such as bone deficiency, previous implant failure and patient preference may restrict their use. Minimally invasive prosthetic alternatives, including resin-bonded fixed dental prostheses, have gained interest. Advances in zirconia biomaterials and digital dentistry have improved the predictability of conservative anterior restorations. This case report aimed to evaluate the clinical feasibility of a dual-wing zirconia Maryland bridge fabricated through a fully digital workflow for anterior tooth replacement following implant failure. A 60-year-old female patient presented with an unesthetic smile due to the loss of a maxillary anterior tooth following implant failure. After clinical and radiographic assessment and a healing period, prosthetic rehabilitation was performed using a computer-aided design and computer-aided manufacturing fabricated zirconia Maryland bridge with dual-wing retention. Surface conditioning was achieved using airborne-particle abrasion (50 μm Xpedent Aluminum Oxide Abrasive Powder at 2.5 bar using a dedicated device (Chair-Side Micro Etching Master 2-in-1, Xpedent Austria GmbH, Lustenau, Austria)) followed by application of a phosphate monomer primer containing 10-methacryloyloxydecyl dihydrogen phosphate (Stela primer (SDI Limited, Bayswater, Victoria, Australia)). Cementation was performed using a dual-cure self-adhesive resin cement (Set Maxx, Southern Dental Industries, SDI Limited, Bayswater, Victoria, Australia) under controlled polymerization conditions. Objective esthetic evaluation was conducted using a digital shade measurement system Cobra Shade Scanner (Borea S.A.S, Limoges, France). The dual-wing zirconia Maryland bridge demonstrated excellent marginal adaptation, mechanical stability and favorable esthetic integration. Minor occlusal refinements enhanced functional harmony and surface appearance. The restoration showed satisfactory clinical performance during the observation period. Dual-wing zirconia Maryland bridges fabricated using a digital workflow may represent a conservative and predictable option for long-term provisional anterior tooth replacement in selected clinical situations. Proper adhesive protocol, digital planning and material selection are critical factors for clinical success.

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