Bridges


 

What are bridges?

It’s a fixed dental restoration, which usually can involve at least two other tooth fixed to an artificial tooth or at least two implants as an alternative, like the above logo.

Similar to the Sydney Harbour Bridge (alternatively ANZAC bridge depending what you’re a fan of) , it consists of three main components:

  • Two pylons (we call that abutment)
  • One arch (we refer that as a pontic)
From Wikipedia Commons

From Wikipedia Commons, photo taken by JJ Harrison

 

We will be discussing three types of bridges used in dentistry

  1. Conventional bridges
  2. Resin Bridges
  3. Implant bridges

 

Conventional (or traditional bridges) bridges

Note: we view this type of treatment as outdated due to the recent advancements in resin bridges and implant dentistry. However, we’ll still explain what its all about as some people still request this treatment.

Conventional bridges typically involve at least 2 teeth between the missing space where we prepare and drill the adjacent teeth (big disadvantage if the tooth had never had a filling). Once the teeth are prepared dental impressions are taken to be sent to a local dental laboratory where it will be custom made for you.  Prior to the increasing evidence of the reliability of dental implants this was the treatment of choice. The main reason why we consider this method outdated is due to the complexity of making a bridge (needing a lot of specific measurements to get it done right) and the large amount of removal of the abutment teeth.

 

Implant bridges

Implant bridges work in a similar concept as the conventional bridge (you still need the pylons and the arch), except that the abutment teeth is now dental implants instead of natural teeth. This prevents us from preparing the adjacent teeth between your missing teeth and allows us to design a better, longer lasting bridge for you. Click here to read more about implants in general.

 

Resin bridges (or known as Maryland bridges)

A resin-retained bridge is type of bridge that relies on the retention of composite resin cement. The abutment teeth of the bridge is made out of cast metal wings which sticks on the inside surface of a tooth. Some degree of tooth preparation is need and it is very minimal compared to the conventional bridge (0.5mm vs 1.0-1.5mm) which is important for the long term health of the tooth. The downside of the resin bridge is that is can only be reliably placed on the upper front tooth. With current dental evidence, it is currently in favour in the United Kingdom because of the mentioned advantages.

 

What are my other options?

Here are the other options in having your missing teeth replaced, including on what we have discussed about bridges:

Treatment optionAdvantages (+)Disadvantages (-)
Dental implants+ Fixed to your existing bone
+ The closest thing to having your original tooth
+ Long term lifespan
+ High success rate
+ Prevents and/or reduces bone resorption
- Cost
- Involvement of multiple dentists and dental specialists

Maryland/Resin bonded bridge+ Relative lower cost compared to dental implants
+ Medium term
+ Fixed to the adjacent tooth after conservative preparation
- Limited to the upper front tooth only
- Will not prevent bone resorption
- There will be a chance of debonding over time (i.e. the bridge unit comes off) but on the plus side it can be rebonded easily
Conventional Bridge
* We personally view this as an outdated method ever since dental implants have been introduced
+ Fixed to the adjacent teeth
- The need to prepare and drill the adjacent teeth (big disadvantage if the tooth had never had a filling)
- Not suitable if you have multiple large gaps to fill
- Relatively complex procedure
- Will not prevent bone resorption (can result from the tooth being replaced under the bridge to have large gaps and food trap).
Dentures+ Relatively quick to make
+ Conservative preparation of the existing tooth in order to make the denture stay in.
+ Good, economical option to fill in multiple gaps in your teeth
- Will not prevent bone resorption
- Because of this, the denture will need to be serviced at least once every 6 months in order to allow the base of the denture to match the change in the bone height.
- Not fixed in the mouth
- Needs to be removed every night
- Good oral hygiene is a must, otherwise the denture can cause the other tooth that is holding it to loosen and exacerbate gum diseases.
- Potential poor tolerance due to people whom have oversensitive gag-reflexes
- May reduce your taste sensations
- May reduce your ability to bite on foods compared to having natural teeth.
Do nothing (i.e. not replacing the tooth)+ Viable choice due to the costs of dental treatment - The alveolar bone where the tooth has been taken will slowly resorb over time once the tooth is lost.
- Because of the above problem, it can make future replacement of your tooth more complex (adding to the cost of treatment).
- Potential aesthetic concern.
- Potential for drifting, rotation and over-eruption of adjacent teeth into the gap over time
- Possible gum problems in the future due to the above scenario

 

So what’s the best for me?

Each person has its own unique needs so it is difficult to tell. The best way to know what you need is to contact us and I’ll sit down with you to go through the best option with you in person.