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Bridges
Bridges are used to replace missing teeth, they are held in place by the teeth adjacent to the missing ones. With bridges the function, size, appearance and strength of missing teeth are restored. Gaps between teeth have to be restored because if three are missing teeth in the mouth, the remaining ones will start to drift out of position and that has bad effects on long term leading to decay and gum disease.
When is a bridge used?
To cover a dental implants
To replace function of missing teeth
To improve appearance in case of missing teeth
To prevent disadvantages of missing teeth
The procedure
To place a bridge, the adjoining teeth have to be prepared. During the first visit your dentist gives you anaesthetic injection to numb the area and prepares the adjoining teeth that serve as anchors for the bridge and takes moulds. The dental technician fabricates the bridgework and during this period, you will wear a temporary bridge. On your next visit the dentist permanently cements it into the mouth and adjusts your bite.
It usually requires 2-3 visits in a 7-10 day period.
Types of bridges
-traditional fixed bridge
Made of porcelain-fused-to-metal, or ceramic material. There is a pontic tooth covering the gap, adjoined by anchoring crowns on either side. They are permanently fixed in the mouth.
-resin bonded bridges, Maryland bridges
Ideal if the adjoining teeth are healthy, and for missing front teeth. Made of plastic material that is fused to metal bands bonded to the adjacent teeth.
Materials used
-metal
Usually gold alloys are used. They have several advantages, they are very workable, a precise fit can be achieved with the tooth surface, less tooth structure needs to be removed, very durable, withstand biting forces, do not chip and do not break. They have the same wear rate as tooth enamel, so they are less abrasive to the opposing tooth. Their aesthetic appearance is their only disadvantage and for this reason they are recommended for molars. It is also advantageous for those patients who grind their teeth during night. They generally require less work to fabricate and last longer than other restorations.
-porcelain-fused-to-metal
They provide a more aesthetic solution for teeth that show when you smile. They have a metal core and covered with tooth colour matched porcelain. Some amount of wearing and chipping can occur, but in case of good quality materials and dental work they can last for up to 15 years. Their disadvantage is that if the gum recedes over time, some metal can show at the gum line and since they have a metal core they are not as transparent as full porcelain crowns.
-all ceramic restoration
They are either made of zirconia or aluminous materials.
They provide a metal free aesthetic restoration with numerous advantages. They do not need a metal core they are thinner and less of the tooth structure has to be removed during preparation. The absence of the metal core allows light transmission through them providing a more natural solution. They are not as durable as gold or porcelain fused to metal restorations and for this reason they should be avoided at sites where the biting forces are heavy.
How long do bridges last?
If you take care of them as your own teeth, maintain good oral hygiene, and do not chew on very hard surfaces such as nutshell they can last up to 15 years.
Alternatives for bridges
Implants are the ideal alternatives, they provide a very natural, long lasting solution, they feel like own teeth. When a missing tooth is replaced by an implant, no adjoining teeth need to serve as an anchor so healthy teeth do not need to be crowned.
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