Application of Additive Manufacturing in Prosthodontics: Rehabilitation of a Missing Central Incisor Using an SLM Printed Maryland Bridge - A Clinical Case Report

AbstractReplacement of missing anterior teeth in adolescent patients presents a significant challenge in Prosthodontics due to aesthetic demands, psychological impact, and limitations associated with definitive treatment modalities during active craniofacial growth. Implant supported prostheses are generally contraindicated until skeletal maturity is achieved, thereby necessitating conservative interim treatment alternatives. Maryland bridges have emerged as a minimally invasive treatment option because they preserve maximum tooth structure while restoring aesthetics and function. Recent advancements in digital dentistry and additive manufacturing technologies such as CAD-CAM and selective laser melting (SLM) have further enhanced the precision and predictability of fixed prosthodontic rehabilitation. A 14-year old female patient reported with a chief complaint of a missing maxillary right central incisor. Clinical and radiographic examination revealed teeth 12 and 21 with adequate periodontal support, which were selected as abutments for Maryland bridge. Conservative palatal tooth preparation was performed followed by elastomeric impression making using putty and light body polyvinyl siloxane impression material. The definitive cast was poured in die stone and digitized using a laboratory scanner. The prosthetic framework was designed using CAD-CAM software and fabricated in cobalt chromium alloy through additive manufacturing using selective laser melting technology. The SLM fabricated Maryland bridge demonstrated satisfactory marginal adaptation, passive fit, aesthetics, and functional stability with favorable patient acceptance. Integration of digital workflow with additive manufacturing improved prosthesis precision, reduced laboratory inaccuracies, and enhanced overall treatment predictability.