The dental bridge - Types, parts and placement of the bridge

The dental bridge is a type of fixed prosthesis that is used to restore missing teeth. In this article we talk about the different types of bridges that exist, the parts that make it up and how it works.

A) The dental bridge: a type of fixed prosthesis

As we mentioned, the bridge is a type of fixed dental prosthesis. This is a treatment using custom-made dental reproductions that are cemented to some previously prepared natural teeth. Fixed prostheses are used to restore damaged parts of teeth or to replace missing teeth.

A1) What parts does a dental bridge consist of?

The dental bridge is composed of two elements: the pontic and the abutment. The pontic is the artificial teeth that replace missing teeth and is attached to the other crowns that make up the bridge. The abutments are the adjacent teeth where these crowns will be cemented. The name of bridges has been adopted because the covers are located on both sides of the pontics, as if it were a bridge between the two banks of a river.

B) What types of dental bridges are there?

The most common is the three-unit dental bridge, but there are other dental bridge formats that can also be considered.

B1) The three-unit dental bridge

The three-unit dental bridge is one that is supported on two adjacent teeth. For its placement it is necessary to carve the neighboring teeth and convert them into the pillars. Once modeled, impressions of the teeth will be taken that will be used to design and manufacture the bridge that will later be cemented on the pillars.

B2) Maryland, another dental bridge model

The Maryland type bridge allows the placement of a bridge without the need to completely grind the surrounding teeth. In this case, only the surface of the neighboring teeth is slightly abraded. Next, some impressions are taken from the patient's mouth, and the prosthesis to be cemented is designed and manufactured. It should be noted that the resistance of this type of bridge is lower, which is why it is usually recommended for areas with little chewing or as a temporary bridge.

B3) The cantilever bridge

One last possibility to replace two contiguous teeth is the placement of a prosthesis that has an extension, also called a cantilever. This prosthesis is only supported on one side, making it more unstable, so it is also advisable to place it in areas with little masticatory load.

C) How is a dental bridge made?

The first thing to do is make a correct diagnosis, which may include x-rays, photographs, intraoral scanners, etc. Once the function and aesthetic demand of the patient has been analyzed, the treatment is planned. If the option indicated is the placement of a dental bridge, the pieces that will act as pillars will be carved. Once the preparation is done, we will proceed to take some impressions of the area to later manufacture the dental bridge. The manufacture of this fixed prosthesis can be carried out in a prosthetic laboratory or by means of 3D printers or milling machines in different materials, depending on the aesthetic and functional demand.

Normally a provisional bridge is placed at the time of carving the dental pieces to cover them, protect them and solve the aesthetic demand until the final bridge is manufactured. This provisional bridge can be digitally designed in advance or made directly in the clinic from a virtual or analogue wax-up of the patient's mouth. It is cemented once the final prosthesis is manufactured. Finally, the occlusion and the fit of the contact points with the neighboring teeth are checked.

C1) What material is the bridge made of?

The use of one or another material for the elaboration of the bridge depends on the anatomical and functional conditions of the patient. If we are looking for resistance, some metals such as titanium, chrome-cobalt or zirconium are usually used. Ceramics are usually chosen if the priority is aesthetic, although they can also be combined with certain metals that provide resistance. Resin is another of the materials used, although its resistance is lower, which is why it is usually used to temporarily replace parts. This option is also the cheapest. A well-made and well-maintained dental bridge can last for many years.

C2) What care does a dental bridge require?

Patients with fixed prostheses need routine care and hygiene to keep them in a healthy state just like natural teeth. Hygiene is even more important in areas where there are bridges, since it is easier for food debris and plaque to accumulate. In order to properly sanitize the bridges, there are various tools such as the superfloss, the irrigator or the interproximal brushes, which are inserted into the space between the pontic and the gum to clean any debris that may become trapped. It is also advisable to avoid biting hard things. with fixed prostheses since they can become uncemented or even fracture. Finally, going to regular check-ups with your dentist will help maintain your prostheses and prevent possible complications.

D) Dental bridge vs. Implant - Which option is better?

Although the bridge is a perfectly functional alternative to replace missing teeth, it is not innocuous, so it is essential to analyze each case individually to choose the most appropriate treatment. In general terms, the implant is usually recommended before the bridge, but both have their advantages and disadvantages.

D1) Advantages of the dental bridge

The first thing to clarify is that not all patients are suitable for implants, so in these cases, the dental bridge would be the only alternative to restore teeth in a fixed way. On the other hand, for the placement of the dental bridge it is not necessary to perform any surgery, something that must be done in the case of implant placement. Lastly, bridges are usually cheaper than implants, a reason that can be compelling in certain situations.

B2) Disadvantages and limitations of the dental bridge

Despite the fact that the dental bridge has some positive aspects, it must not be forgotten that it is necessary to carve the adjacent teeth to place it even when they are healthy. In the same way, unlike what happens with the implant, with the bridge there is no stimulus to the dental bone, so it can begin to be reabsorbed over time, affecting aesthetics and function. It can also happen that, if one of the pillars of the bridge suffers damage or a cavity and it is necessary to extract it, a new bridge will be needed, carving another tooth that acts as an abutment, or, failing that, the placement of dental implants.

Category Implantology
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