Dental bridge: what it is, types of bridges & who needs it

Tooth loss in adults is a common problem that more and more people face every day. Unfortunately, due to the passage of time, lack of proper dental care, accidents and often heredity, people can suffer from partial adentia (defects in the dentition) in adulthood. And this defect can only be corrected with dental implants or prosthetics.

In this article, you will learn more information about one of the types of dentures, namely the bridge prosthesis, in what cases it is used, its advantages and disadvantages.

What is a dental bridge

A bridge is a fixed structure consisting of a prosthesis and crowns, which are attached on both sides to adjacent teeth. In other words, in order to install a bridge, it is mandatory to have two supporting teeth between which the bridge will be «bridged». For a more secure fixation, the supporting teeth must be ground down according to the technical parameters of the chosen material, so that crowns can be placed on them more tightly. This must also be kept in mind.

Thanks to this construction, one to several missing teeth can be restored in a short period of time without the use of implants.

But the more teeth that need to be restored with such a prosthesis, the more complex the work will be, as more technical parameters will need to be taken into account to prevent fracture of the dental bridge and to ensure a secure fit.

Types and classification of dental bridges

There are many variations of bridges, depending on the material, type of attachment, shape, method of manufacturing and more.

The dental bridges are differentiated according to the material from which they are made:

Metal-ceramic

They are a metal framework lined with ceramic. It is suitable in many situations, especially in complex defects where 2-3-4-5 teeth have been lost. It is the metal-ceramic bridge that is best placed on chewing teeth due to the strength of the metal inside the bridge. Metals are also different and their properties are different.

Zirconium

Most often used when 1, maximum 2 teeth are lost. As longer prostheses require a rather large area of tooth connection, which is not always possible and therefore such bridges can break in more complex constructions. However, they have the best aesthetic properties and most importantly are the most biocompatible, which makes them a favourite when a bridge is needed on anterior teeth and on small defects in lateral teeth.

All-ceramic from lithium disilicate (ЕMAX)

These prostheses are the best balance between aesthetics and functionality, but it is better not to place them on chewing teeth, because the ceramic under high pressure can break.

Plastic

They are used as a temporary solution while waiting for a full dental bridge to be made from more stable materials, as plastic is not able to withstand serious stresses.

According to the type of manufacturing, dental bridges are divided into:

  • full-cast;
  • Maryland, or adhesive (composite dental bridge without grounding down of the neighbouring teeth).

Full-casts are the most reliable, as they are more durable and fit more closely to the supporting teeth.

In terms of shape, dental bridges are divided into straight and arched, which in turn depends on the number and location of the lost teeth.

Which bridge is best for teeth?

Any bridge is good, but you have to depend on the patient’s specific situation.

Metal ceramic dental bridge

If many teeth are missing, a metal-ceramic dental bridge will be more durable. Also, as mentioned above, if the question is “Which bridge might be recommended for chewing teeth?”, it will be a metal-ceramic one in case of large defects, and full-cast zirconia one in case of small defects.

But it should be remembered that a metal ceramic dental bridge consists of three layers: metal, primer and ceramic cladding. And it turns out that this prosthesis in the process of chewing during the year the outer layer, under which the primer lies, is worn off. It is somewhat similar in density to sandpaper, and as a result it gradually begins to rub off the opposing teeth. Thus, the bite begins to lower. Over the course of several years of wearing such a bridge, the opposing teeth are erased, which can lead to additional manipulations and costs to restore the bite.

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Zirconia bridge prosthesis

Unlike metal-ceramics, a zirconia bridge, if polished, does not create the effect of erasure of neighbouring teeth. However, it can break, which is its main disadvantage in case of large defects (3 or more missing teeth)

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Ceramic bridge prosthesis

These prostheses are a golden mean between aesthetics like zirconia and reliability like metal-ceramic. However, they should not be used for chewing teeth. This is basically the alternative solution for today. Due to the durability of zirconia, ceramic is going to single crowns for aesthetics.

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Can I get a bridge on my front teeth?

As can be deduced from the information given above, if there are supporting teeth, it is possible to place a bridge on the anterior teeth. But another question arises – if will be the patient satisfied with the aesthetics of the bridge in the absence of a proper gingival level at the site of the extracted tooth? Perhaps, especially if it has been a long time since the loss of the front tooth, there will be a need for gum grafting to improve aesthetics and functionality (so that food does not penetrate the gum and cause inflammation).

Manufacturing and placement of a bridge prosthesis

Before a dental bridge can be placed, there are several steps that must be completed:

  • The doctor’s part. Cleaning and treatment (if necessary) of the teeth, anaesthesia, right shaping of the teeth, impression of the teeth and transfer of the impression to the laboratory.
  • Manufacturing. A framework made of zirconium, ceramic or metal is created in the laboratory, after which it is tried on if necessary. In the digital protocol, the plastic prototype is also tried on for fit and aesthetics. The prosthetic prototype is then returned to the laboratory.
  • Fitting. In the laboratory, the veneering takes place (if it was a metal frame), after which a second fitting takes place in terms of colour and appearance, shape and fit of the bridge on the teeth. (In case of the digital version, at this stage the patient is given a ready-made version).
  • Placement. After the bridge is finalised after a second fitting, the patient’s temporary dentures are removed and the permanent prosthesis is placed.

Dental bridges: Frequently asked questions

Many patients have additional questions about dental bridges. Here are some of the most popular ones, but if you don’t find your question here, you can make an appointment for a consultation, where your case and all related questions regarding prosthetics and more will be discussed individually.

What I should to do if the dental bridge moves?

In this case, there are three possibilities as to what happened:

  • The easiest one is that the bridge has come off.
  • There’s a rotten tooth under the bridge.
  • Broken tooth.

In the first case, you will simply need to revisit the doctor to have the bridge fixed. The bridge will not need to be replaced.

In the second or third case, you will most likely need a longer bridge with two more teeth or an implant. Consult your dentist for a more precise plan of action.

What should I do if I have tooth pain under my bridge?

You need to understand what is wrong with the tooth, so x-rays will need to be taken to assess the situation. If the tooth is alive, there is a high probability that it is pulpitis or periodontitis. If this is the case, nerve removal and root canal treatment will be required. The doctor may decide to treat the tooth through a crown (without removing the bridge), but this results in the bridge having to be “compromised” in some ways, but it will not break and will not need to be re-installed. Otherwise, there is a high chance of breaking the neighbouring teeth, after which you will only have to go through the implants.

What should I do if my dental bridge falls out?

If your prosthesis has fallen out, you should in any case go to the dentist and assess the condition of the supporting teeth. If they are in good condition, a new prosthesis should be made to replace the old one. If they are in bad condition, the doctor will see if he can treat them and prepare them for a new prosthesis. If not, either another bridge (longer), implants or a plate is planned.

A dental bridge has broken – what to do?

If a bridge is broken, you have to remove it anyway, file it down and assess the teeth to see if they are suitable for re-dentures.

Which is better: an implant or a bridge?

It all depends on the individual characteristics of the patient and the initial situation. If it is possible to place a dental implant, it is better to favour this option. However, if additional complications arise, such as insufficient bone, a bridge is a good alternative.

Does it hurt to remove a dental bridge

No, the procedure of removing the bridge process is painless, as this manipulation is carried out under anaesthesia.

What is the service life of a dental bridge?

The service life of a dental bridge can vary depending on the individual, hygiene and care of the patient. On average, a dental bridge lasts about 10 years, but this figure can be less or more.

On the front teeth, crowns are better to be placed separately or in a bridge

The situation is at the discretion of the dentist and the patient’s requests.

It should be remembered that the front teeth are an aesthetic zone, which means that it is better to place crowns separately. But a dental bridge may be required if some technical parameters do not provide stability and strength of the structure. If you do not have a front tooth\teeth, if possible, it is better to give preference to implants.

author
ALEKSANDR MAKAROV
Dentist, surgeon, orthopedist
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