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Dental prostheses are inherently expensive, especially fixed ones. Today I'm going to talk about a dental prosthesis that was almost forgotten with the advent of dental implants, but which can be made inexpensively. The Maryland bridge is a fixed, adhesive prosthesis made of metal and porcelain that is cemented or glued to the palatal or lingual surface of the teeth adjacent to the missing tooth. This solution is indicated in cases where the available space is too small for an implant, or as a temporary, fixed solution while the dental implant osseointegrates. It stabilizes the occlusion and promotes the maintenance of adjacent teeth. Indications: Patients without periodontal disease on clinical radiographic examination. Young patients with intact enamel or, failing that, with small carious lesions confined to the enamel or the dentin-enamel border. For the replacement of the first premolar, upper and lower incisors, and canines. Molar replacement is not recommended, but it may be an option for women, given their lower chewing strength compared to men. Patients with good dental hygiene (O'Leary index equal to or less than 20%). Once implanted, the patient must be trained in the use of an interdental brush. Contraindications: Abutment teeth with grade I mobility or greater. When the distal and mesial sulcus of the abutment teeth have a pocket depth greater than or equal to 5 mm. When the disocclusion mechanisms are absent. Patients with signs and symptoms of centric or eccentric brusciism. Patients with poor hygiene and dietary habits. Dentin is not a suitable surface for the installation of adhesive bridges. When the mesiodistal space to be occupied by the pontic is greater than the mesiodistal width of the homologous contralateral tooth. Advantages: Minimal enamel wear compared to conventional fixed prostheses. Infiltration anesthesia is not usually required. In case of failure, treatment with conventional fixed prostheses is possible. Reduced cost compared to dental implants and conventional three-unit fixed prostheses. Mechanical stress lifespan similar to conventional fixed prostheses (with an average of 8.5 years of lifespan, maintaining aesthetics and function) in 50 registered cases. Grinding technique similar to removable partial dentures (grinding of occlusal rests and guide planes, with certain modifications). Does not require temporary crowns to protect dental stumps. Aesthetics superior to a conventional bridge. The dental technician must have the art and science to mimic the contralateral homologous teeth. Disadvantages: Patient selection must be carefully selected; therefore, this treatment is not suitable for the general population. Metal is usually visible on the palatal and lingual surfaces of the abutment teeth. For Maryland bridges constructed with all-ceramic, the carving process must be deeper to increase the strength of the ceramic. Therefore, it is often a contraindication due to the amount of tissue removed. Impeccable technique is required during the impression and cementation steps. For cementation, the use of a rubber dam is essential, given that an adhesive technique is used. (Acid etching and bonding agent, with dual luting resin) Glass inomer cementation is an option in cases of relative isolation, when orthophosphoric acid etching of the tooth enamel is not possible. Technique A history, examination, and correct diagnosis, along with proper positioning of the patient and the professional, the use of appropriate technique, and aseptic measures are essential standards for the construction of a Maryland bridge. First, a thorough assessment of the occlusion must be performed, and then the supporting teeth must be properly anesthetized. The teeth adjacent to the defect are properly prepared, and impressions are taken with the appropriate material following the manufacturer's instructions. After pouring, the bridge is fabricated, fitted, and adjusted. The supports are then cemented with a special cement. Complications Complications can affect the teeth supporting the bridge. Occasionally, the bridge supports can become debonded.