Bridging the Gap
In the world of cosmetic dentistry, conventional dental implant procedures are the gold standard and treatment of choice for edentulism or tooth loss. Unfortunately, conventional implants may not be the right solution for every patient. Conventional dental implant surgery requires adequate bone structure and good health. For many patients, this may be a barrier. There are also higher costs associated with a conventional implant solution, depending on the number of missing teeth. Fortunately, there are effective, aesthetic, and affordable options available. One highly recommended alternative to conventional dental implants is the use of dental bridges to replace missing or irreparably damaged teeth.
What Are Dental Bridges?
Dental bridges essentially bridge the gap left by missing teeth. They are any kind of prosthesis screwed or mechanically attached to existing teeth or an implanted abutment to support a dental prosthesis. Typically, a bridge consists of an artificial prosthesis composed of one or more replacement teeth. This prosthesis is then secured in place on both ends by existing teeth called abutment teeth. The false teeth which span the gap are referred to as pontics. Bridge procedures can be readily distinguished by the manner in which the bridge work is secured and anchored in place.
5 Types of Dental Bridges
Dental bridges are often divided into two categories: conventional bridges and alternative bridges. Conventional bridges, as the name suggests, are the most common dental bridge procedure. Conventional bridges require reshaping of the adjacent abutment teeth to accommodate crowns. Alternative solutions consist of anchoring techniques that do not require reshaping adjacent teeth. These alternative solutions can utilize resin-bonded wings or strategically placed dental implants.
1. Fixed-Fixed Conventional Bridge
A fixed-fixed conventional bridge is a type of traditional bridge that is permanently fixed in place by rigid connectors, typically crown abutments, on both ends, which prevent any lateral movement. Fixed-fixed conventional bridges are the most popular types of bridge. They are easier to handle and install than other types of bridges, and provide cross-arch splinting and support. Unfortunately, their relative rigidity can also cause issues. The natural movement of abutment teeth over time can result in gaps and noticeable margins. Rigid fixed-fixed bridges are also susceptible to bending damage.
2. Fixed-Movable Conventional Bridge
Unlike a fixed-fixed conventional bridge, which is rigidly affixed to both ends, a fixed-moveable conventional bridge is only fixed on one end and movable at the other end. The moveable connector allows the abutment tooth to which it is attached to move slightly in a vertical direction. This is critical as it allows patients to flex their mouths without bending the rigid prosthesis. However, the added flexibility and comfort added to a fixed-moveable solution also comes with some drawbacks. First and foremost, fixed-moveable solutions simply require more space. Flexing of the bridge may also occasionally reveal metal components of the bridge, which some may find aesthetically unacceptable. Fixed-moveable conventional bridges may also suffer from the potential wearing of the moveable joint itself over time, which may reduce the lifespan of the prosthesis.
3. Cantilevered Conventional Bridge
With a cantilevered conventional bridge solution, the bridge prosthesis is only affixed to an abutment crown on one end. Due to the nature of this type of bridge, only a single pontic can be attached utilizing a cantilevered system. This kind of bridge cannot be used to treat large gaps or areas of edentulism spanning multiple teeth. Because cantilevered bridges are only fixed at one point, they are also susceptible to tilting over time as occlusal, or bite; forces may cause the abutment tooth to move. While only adequate for limited applications, cantilevered bridges have the benefit of reducing the amount of intervention, and subsequent pulp trauma, demanded by other conventional solutions.
4. Maryland-bonded Bridge (Resin-bonded Bridge or Acid-etched Bridge)
Maryland-bonded bridges, also commonly known as resin-bonded or acid-etched bridges, are not considered a type of conventional dental bridge. Instead of relying on adjacent abutment teeth to support a dental prosthesis or pontics, Maryland-bonded bridges utilize a pair of wings which are affixed to the adjacent teeth with resin cement. This preserves the integrity of the adjacent teeth since little to no damage is done to these teeth in the process. However, Maryland-bonded bridges are not as structurally resilient as conventional bridge types, and the metal framework can look somewhat artificial. As a result, Mary-land bonded bridges are almost exclusively employed in the front of the mouth where the wings can be more efficiently hidden behind existing teeth.
5. Implant-Supported Bridge
While many dental patients opt for dental bridges as an alternative to conventional dental implants, implant-supported bridge solutions offer an excellent compromise between the two prosthodontic solutions. Rather than replacing every single target tooth with an individual conventional implant, implant supported bridges rely on only a few strategically-located implants to provide support for a prosthetic bridge. Depending on the size and scope of the area affected by edentulism, perhaps only one or two implants may be required to provide the necessary amount of support. Once an abutment implant is in place, the bridge procedure can go forward as it typically would.
One full-mouth variation of the implant-supported bridge is the All-On-Four© dental implants. Strategically embedding only four implants per arch provides support for a full arch bridge work. All-On-Four© dental implants provide a compromise between conventional dental implants and traditional dental bridges. All-On-Four© dental implants also offer the longevity and sound support of dental implants with the capability to span large gaps provided by a bridge prosthesis. This allows patients to enjoy the best of both worlds at a price that reflects that middle ground.
How Can Dental Bridges Help
Your smile is important. Not only is it an outward facing expression of your own positive emotions and a powerful communication tool, but it can also be an inward measure of your own self-confidence. The truth is, happy people smile more. And those who smile more are happier. So what’s holding back your smile? Is it bad teeth? Does your real smile contain gaps, blemishes, or missing teeth that are making you think twice about smiling wide and smiling often? With all the tools of modern cosmetic dentistry and the expertise and experience of the staff at ArtLab Dentistry, there truly is no reason to let missing teeth hold you back. A full range of aesthetic and functional solutions for tooth loss are available such as implants, dentures, and bridges.
Those considering receiving treatment for edentulism, or missing teeth, should consider the pros and cons of each solution. Let's start by looking at dental bridges.
Dental bridges are custom-fabricated prosthesis that literally bridge the empty gaps left by missing teeth. To work successfully, however, bridges rely on the teeth adjacent to the empty gap, sometimes referred to as abutment teeth, to provide structural supports. The pontics, or false teeth, typically span the gap while existing adjacent abutment teeth undergo a certain amount of reshaping to receive the complete bridge prosthesis. Due to this limitation, patients who suffer from severe or complete edentulism are often not able to effectively utilize bridge-based solutions. Bridges work best for gaps that span only one or two missing teeth.
Bridges offer a cost-effective solution for patients with one or two missing teeth looking for permanent and aesthetically pleasing results. Bridges can repair a broken smile and restore the ability to eat, chew, and speak normally. Just as importantly, bridges also ensure that a patient’s existing healthy teeth do not migrate into the gaps, resulting in malocclusion and misalignment. Dental bridges also have some advantages over other tooth replacement alternatives, mainly conventional individual implants.
Dental Implants vs. Bridges
Conventional individual dental implants consisting of an implanted metal post, or abutment, supporting an artificial crown is the gold standard for tooth replacement. However, dental implant procedures can be more expensive, and can require longer recovery periods. Some patients may also need a prerequisite bone grafting procedure to ensure adequate jaw bone depth.
Bridges are a good alternative for patients who cannot or do not wish to undergo a more involved implant procedure. With a bridge treatment, nothing needs to be permanently embedded into the jaw bone. However, like a dental implant procedure, a typical bridge procedure will necessitate some permanent modifications.
First, a preliminary gum recontouring procedure is often necessary. Second, the abutment teeth adjacent to the area of tooth loss must often be shaped to receive the bridge prosthesis. The procedure results in the permanent loss of some enamel.
The Process of Getting a Dental Bridge at ArtLab Dentistry
The process of getting a dental bridge at ArtLab Dentistry typically consists of 4 steps:
1. Initial consultation
2. Tooth prep, scans, impressions, and fitting
3. Temporary bridge placement
4. Permanent bridge placement
The fitting and placement of temporary bridges often coincide with the initial consultation which means that the entire process of receiving a brand new smile with a dental bridge at ArtLab Dentistry can happen in as few as three appointments.
1. Initial Consultation
The initial consultation is simply a time for you to consult with Dr. Mamaly Reshad, a world-renowned prosthodontist. During your appointment, Dr. Reshad will get a complete understanding of what you want to achieve. He will also evaluate your current health, health history, and health needs before making a recommendation based on your needs and desires. If a dental bridge is the right solution for your missing tooth or teeth, he can assist you in moving forward to the next step, the fitting process.
The fitting process is one of the most important steps in any dental procedure involving custom fabricated prosthesis. Remember, bridges are permanent replacements for your teeth and once put in place will remain for the foreseeable future. That’s why the right fit is so important not only for comfort but also to ensure the correct bite, jaw alignment, and distribution of the forces of mastication.
The first step of the fitting process is to reshape the abutment teeth to receive the bridge prosthetics. Once the abutment teeth are the correct size and shape, Dr. Reshad will take an impression of the teeth around the target area, including the reshaped abutment teeth, from which a fabricator will create a custom bridge consisting of crowns and pontics.
3. Temporary Bridges
While the final bridge is being fabricated, Dr. Reshad will install a temporary bridge made in-house that will protect exposed teeth and gums while the final bridge prosthesis is being created. This temporary bridge is made from acrylic and cemented into place with a special, temporary dental adhesive that can be easily removed at a later date.
Due to the transitional nature of this temporary bridge, it is important for patients in this phase of the process to avoid certain foods and activities to ensure the integrity of their temporary bridges.
Regular, routine brushing and careful flossing are recommended. Crunchy foods should be prevented.
4. Permanent Bridges
During the next appointment, the transitional bridge is removed and replaced with the permanent bridge. Once a good position and fit are determined, the final bridge is cemented in place. This permanent prosthesis is much stronger and more resilient than the temporary one and should be able to stand up to the rigors of daily life.
To ensure the best fit and maximize the life of the dental bridge, we may recommend follow-up visits to address any concerns as well as ensure proper and good fit.
At ArtLab Dentistry, we are determined to ensure a perfect fit, and that you are delighted with your new bridge work and beautiful smile.
Our goal at ArtLab Dentistry in Woodland Hills, CA is to make your dental experience remarkable. If you would like to arrange for a consultation with Dr. Reshad call our office at 818-465-5041 or use our online appointment form by clicking the button below. We look forward to hearing from you.