A dental bridge is a restoration that replaces missing teeth by using adjacent teeth or dental implants for support. It is also commonly known as a fixed denture.
Benefits of a dental bridge.
A dental bridge is able to restore your smile, maintain lip support, allow you to chew and speak normally by literally bridging the gap where one or more teeth may have been loss. It is fixed and can often be fabricated in two visits, making it a lifestyle friendly and convenient option.
What will the dentist do?
The dentist starts by examining the location, no of missing teeth, the way you bite and the condition of the supporting teeth. He may recommend for you to take small x-rays of the supporting teeth if he is concerned about their health. Your dentist will also try to find out more with regards to your expectations on the appropriate appearance and longevity of the dental bridge.
Treatment consist of shade selection followed by careful preparation of the supporting teeth to ensure that they have an optimal taper, well defined margins, adequate ferrule and clearance from adjacent and opposing teeth. An impression of the teeth preparation is taken and sent to the dental laboratory to facilitate fabrication. Temporary crowns are made and fitted over the prepared supporting teeth in between visits.
On the fitting appointment, the temporary crowns are removed and the dental bridge tried in. Your dentist will check to ensure that the bridge is able to seat well, have good margins and is in contact (or suitable relationship) with adjacent and opposing teeth. He will also invite you to help assess the colour and overall appearance of the dental bridge. The bridge is cemented in place once it is deemed to be satisfactory.
How long will it take?
The procedure can often be completed within two visits. The first visit is for preparation of the supporting teeth (takes approximately 90 minutes on average) and the second visit is for bridge fitting (takes approximately 30 minutes on average).
What will the experience be like?
Teeth preparation is usually done under local anaesthetic with the exception of root canal treated teeth. The procedure is painless albeit a little tiring for the patient, due to prolonged mouth opening, especially for back teeth. Dental bridge fitting is fairly straightforward whereby the temporary crowns are replaced by the permanent dental bridge.
How do I decide on the type of dental bridge?
Dental bridges can be made entirely metallic alloys, ceramic or in combination with an outer layer of porcelain to maximise strength and simulate the appearance of natural teeth. Commonly used varieties include:
Metal dental bridges
Metal dental bridges can be fabricated from alloys of noble (e.g. gold, palladium, platinum and silver) and base metals (e.g. tin, copper, nickel, chromium). Full gold dental bridges are of a better quality when they are high in noble content (at least 60% noble metal, of which at least 40% must be gold). Metal bridges require less removal of supporting teeth structure, causes less opposing teeth wear and is able to withstand chewing forces well. The metallic colour is the main drawback, making them a good choice to replace out-of-sight molars, especially in patients with a strong bite or grinding habits.
Porcelain fused to metal dental bridges
These are hybrid dental bridges made of a metal core and an outer layer of porcelain. The metal core provides strength while the porcelain mimics the colour, translucence and fluorescence of natural teeth. Porcelain fused to metal dental bridges attempts to seek the best combination of durability and appearance. Sometimes the metal beneath the porcelain can show through as a dark line, especially at the gum margins of supporting teeth with receded gums.
Alumina reinforced dental bridges
Alumina reinforced dental bridges are made of a glass infiltrated alumina core and an outer layer of porcelain. It has very good aesthetic qualities, although it is not as strong as porcelain fused to metal dental bridges. It is more suitable across short spans or areas which are subjected to light chewing forces.
Zirconia dental bridges
Yttria-stabilized zirconia oxide is the hardest material used in dentistry to restore teeth, making it a good choice for replacing missing molars. Monolithic zirconia dental bridges are made entirely of zirconia oxide and come in a variety of tooth-like shades. Zirconia cores can be layered with porcelain to further improve its colour, translucence and fluorescents although it does not form a very strong bond with porcelain, rendering it more susceptible to chip.
Are there any risks?
Patients should always weigh the pros and cons of a dental bridge carefully as your dentist will need to remove between 1.0mm and 1.5 mm of enamel from the supporting teeth to accommodate the dental bridge. Dental bridges need to be diligently maintained with a combination of good personal hygiene and professional care. Failure to do so may lead to premature failure due to decay or gum disease affecting the supporting teeth. Another common problem is porcelain fracture due to heavy biting, flexing of the dental bridge during function or grinding habits. This can be mitigated with the selection of full metal dental bridges, appropriate treatment planning or the use of a night guard when sleeping.
Modern dental bridge material is biologically compatible and can last many years if properly cared for. The average lifespan is between 5 and 10 years. The decision to replace dental bridges often hinges on the health and appearance of the supporting teeth as well as its neighbours.