Dental bridge - (fixed partial denture)
A traditional dental bridge is made to replace one or more missing teeth by using crowns (or caps) on the teeth next to the empty space (called abutments) on both sides that serve as anchor points for the dental bridge . A replacement tooth (called a pontic) is attached between the abutment crowns (much like a bridge that is supported by land on both sides of the water it crosses) and is fixed in place as a one piece unit.
Why do we use a dental bridge ? The obvious benefit of replacing a missing tooth is for esthetic and chewing purposes. However, gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces due to uneven forces, resulting in a bad or collapsed bite. The unbalanced force caused by missing teeth can lead to the eventual damage or loss of other teeth as well as gum disease or temporomandibular joint (TMJ) disorders.
A dental bridge can be supported by :
1) all natural teeth 2) all implants or 3) combination implants and teeth - (least desirable).
As with single crowns, there is a variety of materials (gold, silver, porcelain fused to metal, all porcelain, zirconia) that can be used to fabricate a dental bridge . Dr. Aurbach will help you decide which is best for you based on the location of the missing tooth, its function, desired esthetics, cost and the condition of the surrounding teeth. If the abutment teeth are strong they can be prepared for the bridge, if they are heavily damaged they may require root canal therapy with a post and core buildup to add structural integrity.
A dental bridge also has many different variations. A true traditional bridge provides maximum support (second only to a single implant and tooth replacement) and function. However, sometimes it is warranted to sacrifice some of that support for other reasons, it is also a more affordable alternative.
Cantilever bridge
A cantilever bridge is held in place by a crown(s) on only one side of the space where the tooth is missing. This type of restoration has less structural support for the pontic than a traditional bridge; it has many applications though. For example, esthetic reasons - when it is not desirable to prepare the teeth on both sides of the missing space or when a traditional bridge is not possible - i.e. there are no teeth on one side of the missing space or one of the abutment teeth is already supporting another prosthetic restoration that, for various reasons, cannot be replaced.
Maryland bridge
A Maryland bridge consists of a metal or composite framework with "wings" or "tabs" on each side that are bonded to the back of the adjacent teeth and the pontic is attached to the framework. The benefits of this style of bridge are the minimal preparation needed on neighboring teeth and ability to keep teeth from shifting by acting as a place holder. A Maryland bridge is only as strong as the material bonding it to the teeth - therefore they do often require repair. They too have very useful applications in dentistry - in an immediate situation (you must leave the office with a tooth now) this style of bridge can be fabricated on the spot at Old Hook Dental. They are also frequently used to fill in a missing tooth on a teenager where an implant will eventually be placed but they are not done physically growing. In a short term application, an even more conservative approach called a Monodont bridge can also be used (see right photo)
What's involved :
Getting a bridge will require a minimum of two visits (with the exception of a chair side Maryland, which is same day), but for larger span bridges it is often more. At the first visit, we will take a preliminary impression of your teeth. Before a bridge can be fabricated, the teeth must be prepared by reducing their size so that the bridge can accommodate for the thickness of the material used. Once complete, a final impression will be taken and a correct shade is selected to match the surrounding teeth for a natural appearance. All of this is sent to the laboratory to fabricate the bridge in the material we specify. Lastly, you will leave the office that day with a temporary bridge to protect the teeth underneath and for you to test out having a new replacement tooth while the permanent one is fabricated (usually around two weeks).
At the second visit, the temporary bridge will be removed and the teeth will be cleaned for cementation of the final bridge or the a framework for the bridge will be tried in and sent back to the lab for final processing. A good lifespan for a bridge is considered to be around seven years but can last much longer (or shorter if you neglect it!). The best practice to increase the longevity of your new bridge is to maintain good oral hygiene. The main cause of bridge failure is usually not a result of the bridge itself, but rather a failure of the supporting teeth (New cavities develop) as a result of improper oral hygiene. Once you receive your new bridge from Old Hook Dental, we will review full care instructions with you.
Call to schedule your appointment with us at Old Hook Dental (201) 358-5005