What is a dental bridge? To replace a missing tooth, there could be few options. There are two major options to replace the missing area: 1) fixed replacement 2) non-fixed replacement. If you want something that is fixed in the mouth, you have an option of either bridge or implant. Otherwise, for non-fixed option, a partial denture could be your option. In this post, we will be discussing the bridge.
There are mainly three types of bridges: 1) traditional dental bridge 2) Maryland Bridges 3) Cantilever bridge.
1) Traditional Dental Bridge
In order to replace the missing tooth, adjacent teeth around the missing area are prepped for a crown. If there is only one missing tooth and surrounding teeth are strong enough, a 3 unit bridge would be recommended, however depending on the number of missing teeth and depending on the strength of the supporting adjacent teeth, it could involve more than 3 unit bridge. Crown procedures are discussed in detail in another post, so please read the article on this link. [https://www.midentalclinic.com/what-is-crown].
Once the adjacent supporting teeth are prepped for a crown, the impression is taken and sent to a lab for the fabrication of the permanent bridge. It could take up to 2 weeks to get the permanent bridge back from the dental lab, and you may be wearing the temporary bridge. It is very important to be careful during wearing the temporary bridge because they are not strong enough to support any major pressure and they are only for mostly esthetic. Once your permanent bridge is ready it will be cemented in your mouth unless any adjustments are not required. Unlike other types of bridges, crown preparation for the supporting teeth are required. However, from the experience, the missing area tends to get significant pressure on chewing thus traditional denture bridge option would be most ideal.
2) Maryland Bridge
This is a more conservative approach to getting a bridge. Instead of crown prepping (cutting) the supported teeth, simply the bridge is “bonded” to the backside of supporting teeth by either metal or porcelain framework. This seems to be a better approach but in reality, on chew bridge tend to get a lot of pressure and either the bonding comes or the metal or porcelain framework fractures. Unless you are very against cutting the supporting teeth for preparation for the bridge or unless the bite of out of occlusion (meaning when you bite opposing arch is not hitting around the area of where you are getting the bridge), this option would be contra-indicated. Please consult your dentist prior to choosing this option.
3) Cantilever Bridges
This is another conservative approach to getting a bridge to fill up the missing area. Unlike the traditional dental bridge approach, instead of both sides of missing teeth being prepped, only one side is crown prepped. The cons would be less tooth structure being cut, however, in order for a dental bridge to be stable securely, you DO need support on both ends. In the long run, the cantilever bridge may fail and the supported tooth may become mobile and ended up losing even the supporting tooth. This option would be very contra-indicated for any area in the mouth where there is pressure due to occlusion.
Typically, traditional bridges are the one that you get from the dental office and it would be ideal for most cases if you want something that lasts for a long time.
There is something called “Ante’s Law” and it states: “the length of the periodontal membrane attachment of the abutment tooth should be at least one half to two-thirds of that of its normal root attachment”. [https://en.wikipedia.org/wiki/Ante%27s_law]
In order to support one missing area, a 3-unit bridge may work but if you have more than one tooth missing, a 4-unit bridge may not work and you may have to extend to the long bridge. Your dentist should explain to you about this. If you are missing a lot of teeth, a partial denture may be an option for you. It is very important that in order for the bridge to work, the supporting teeth must be in good sound condition, meaning no major periodontal problem or cavities. After all, you are spending a lot of money on the bridge and you want to make sure the prognosis is worth the money.