Dental bridge: how and why

Dental Bridges – common questions about bridges answered

What are dental bridges?

Dental bridges are a tooth replacement option to fill a gap created by one or more missing teeth. Bridges are made of at least one crown which is attached to the tooth next to the gap being replaced. A matching replacement (pontic) tooth is anchored to crown(s), filling the gap.

 

What are dental bridges made from?

The replacement tooth can be fabricated from a range of durable materials such as porcelain, gold, zirconia and other alloys. Not only do bridges restore your smile aesthetically, but they also restore the functionality of your mouth.

 

What are the four main types of bridges?

  • Conventional
  • Cantilever
  • Maryland
  • Implant supported

 

Conventional

Conventional bridges are recommended when the teeth either side of a gap are present. The process involved in making a conventional bridge is firstly reshaping the teeth either side of the gap, creating and then cementing the restoration which has the false tooth in the gap.

 

Cantilever

Cantilever bridges are ideal when there is only one tooth present next to the missing tooth. As there is only one tooth for the replacement tooth to be anchored to, there are certain risks involved with cantilever bridges. The forces on the one supporting tooth may compromise it.

 

Maryland

Maryland bridges are one of the more conservative bridge options. They are similar to conventional bridges, however, as opposed to reshaping the teeth, they are attached to the adjacent teeth with a metal or porcelain “wing”. The benefit of Maryland bridges is the use of resin cement to hold the bridge in place, with the dentists only needing to very minimally adjust the natural teeth. Resin materials have significantly improved in recent years. However, they may be deboned as they are limited by the strength of the resin.

 

Implant-supported bridges

For replacing missing teeth, implanted supported bridges are the most stable option. The first step for an implant supported bridge is the careful surgical placement of titanium screws into the jawbone where there missing tooth. After a healing period, the fabricated replacement tooth is attached to the implant which has integrated into to the bone.

 

While implant supported bridges are the most stable option, each patient needs to be assessed to ensure there is enough bone as well as good quality bone. The investigations may include x-rays, CT scans, photographs and other diagnostic tests.  Some considerations before getting an implant support bridge include; the additional time they require to complete, they are more invasive, and the fee for implants is generally more than other bridges. Despite this, they are a good option because they do not compromise adjacent teeth and have the potential to last a lifetime.

 

How do I know which bridge is best for me?

The type of bridge is determined by where the missing tooth/teeth are, the condition of the teeth surrounding the missing tooth and personal factors such as general health, budget and individual preference.

 

Information about different types of dental bridge materials

Silver, gold and metal alloys

  • Strongest material
  • Requires less reshaping of natural tooth
  • Good option for back teeth which generate strong forces
  • Aesthetic contrast

 

Ceramic

  • Thicker and less durable than metal
  • Natural teeth need more adjustments
  • Tooth coloured and easy to match to natural teeth either side

 

Zirconia

  • Material is a dental ceramic
  • Similar strength to metal
  • Natural teeth below do not need much reshaping
  • Great aesthetics to match adjacent teeth

 

Porcelain-Fused-to-Metal (PFM)

  • Strengthened by a metal base
  • Porcelain on the outer surface to match the natural teeth
  • Thicker due to two layers of materials