A dental bridges serve as a solution for replacing one or more missing teeth or addressing gaps between teeth. While some individuals may refer to a removable appliance for missing teeth as a bridge, dentists typically do not. Dentists reserve the term “bridge” for a fixed restoration that adheres to natural teeth with dental cement, rather than being removable. Bridges come in various materials and designs, generally categorized into four types.
Universal factors to consider for all dental bridges
In every form of dental bridges, the artificial tooth is referred to as a “pontic.” The pontic serves as the chewing surface and is linked to the supporting structure through components known as retainers. (The design of the retainers varies depending on the type of bridge).
Every bridge relies on adjacent structures for support (typically neighboring teeth), with the pontic resting atop the gum tissue and jawbone rather than penetrating them. Additionally, bridges necessitate specific oral hygiene practices due to their connections with adjacent teeth, which can inhibit standard flossing.
Each bridge depends on adjacent structures for support, usually neighboring teeth, while the pontic rests on the gum tissue and jawbone rather than penetrating them. Moreover, bridges require particular oral hygiene routines due to their connections with neighboring teeth, potentially hindering regular flossing.
The chewing force exerted by the pontic does place additional stress on the neighboring teeth as they absorb the extra force. This is why the size of the replaced tooth must be notably smaller than the size of the supporting teeth.
The most prevalent form of dental bridges are referred to as a traditional bridge. It employs dental crowns to fully encase the visible portion of neighboring teeth on either side of the missing tooth area. The pontic is linked to the supporting crowns, creating a unified structure. A bridge comprises the number of pontics along with the supporting crowns on each side, thus a traditional bridge replacing a single missing tooth is known as a three-unit bridge.
Traditional bridge
The most prevalent type of dental bridges are commonly referred to as a traditional bridge. It involves the use of dental crowns to fully encase the visible part of adjacent teeth on both sides of the missing tooth. The pontic connects to the retainer crowns, creating a unified structure. The bridge comprises the number of pontics plus the retainer crowns on each side. Thus, a traditional bridge replacing a single missing tooth is known as a three-unit bridge.
Traditional bridges are ideally suited for replacing one to two missing teeth. Their durability and resilience rely on the root structure and the periodontal support (surrounding bone and gum) of the supporting teeth. Dentists must select supporting teeth with lengthy roots and robust bone and gum support to ensure the longevity of the bridge over many years.
Cantilever Bridge
A cantilever dental bridges employ a retainer on just one side of the pontic, resulting in the pontic having only one connection to a retainer. To visualize a cantilever bridge, envision a diving board extending over a swimming pool, with the far end of the board flexing under weight.
The primary retainer utilized in a cantilever bridge is often a complete dental crown. When deciding on the retainer tooth, it’s essential for both the patient and dentist to opt for the tooth with the most robust root and supportive structures around it. Typically, this responsibility falls upon the tooth adjacent to the gap.
The potential for flexing in cantilever bridges raises concerns. There are very few instances where a cantilever bridge can maintain functionality over an extended duration. More commonly, the flexing and torsional forces permitted by the cantilever design either dislodge the bridge or harm the supporting retainer tooth.
Cantilevers can be a suitable replacement choice for very small front teeth with minimal to no chewing force.
Maryland Bridge
A Maryland dental bridges offer a twist on the conventional design by employing small wings as retainers instead of full dental crowns. These wings sit on the biting surface of neighboring teeth and are affixed using bonded dental cement. Maryland bridges are excellent choices for replacing a single front tooth, representing the most conservative type of dental bridge. They necessitate minimal, if any, removal of healthy tooth structure.
Maryland bridges are not ideal choices for posterior teeth as they can be easily displaced by strong chewing forces. Their usage on back teeth is typically considered a temporary measure at best.
One drawback of a Maryland bridge is the potential for it to become debonded and dislodged. Since these bridges are commonly employed for front tooth replacements, such incidents can result in awkward dental emergencies. It’s crucial for recipients of Maryland bridges to recognize that once debonded, this type of bridge is prone to experiencing the same issue again. Subsequent bonds are typically not as secure as the initial one.
Implant-Supported Bridge
An implant-supported bridge adopts the same structure as a conventional bridge but utilizes dental implant abutments instead of neighboring teeth as retainers. The bridge’s retainers, which cover the abutments, also take the shape of full dental crowns, with the abutments prepared in a manner similar to a tooth being readied for a crown.
An implant-supported dental bridges hold an advantage over a traditional bridge in that dental implants and abutments are not susceptible to cavities, thus lowering their failure rate. Traditional dental bridges frequently fail because of the emergence of new cavities on one or both of the retainer teeth. However, both traditional and implant-supported bridges can be compromised by periodontal disease, which deteriorates the surrounding bone and gums of both natural teeth and implants.
Implant-supported bridges come with several drawbacks. They necessitate a surgical procedure for implant placement into the jawbone, adding to their expense compared to traditional bridges. Moreover, the duration required for implant integration into the bone makes this bridge option the lengthiest in terms of time.
The presence of dental implants providing support and the absence of cavity susceptibility make this dental bridges option the one with the highest long-term success rate.
