Replace a missing tooth with a bridge
Dentists can replace missing or lost teeth with a dental bridge that can be undetectable to the eye. Choosing the best types of dental bridge option depends upon many factors. Those factors include:
- The condition of the teeth adjacent to the space
- The shape and the amount of shrinkage of the boney ridge after the extraction of the original tooth
- Gum tissue thickness and symmetry of the gum scallops
- How the teeth show in the smile
- Health of the gums
- Budget considerations.
A tooth bridge can be made to appear as though the tooth was never lost. Advancements in design techniques have increased the our ability to make it look as though nothing ever happened. Dr. Fondriest works with his favorite if necessary to achieve amazing results.
WHAT IS A DENTAL BRIDGE
Tooth bridges are used to replace missing teeth. If you have missing teeth, your dentist can close or bridge the gaps in your smile with them. A dental bridge has a false tooth (called a pontic) that is held in place by the abutment teeth on either side of the gap. They are cemented to natural teeth or implants surrounding the space where the tooth once stood.
Gaps left by missing teeth can cause the surrounding teeth to shift. This can result in a bad bite. Bridges help prevent this bite collapse from happening.
Dental bridge types
There are four types of dental bridges:
1) All Porcelain Bridge
When dental implants cannot be used to replace a missing tooth, then permanently cemented types of dental bridges are the next best solution. These non-removable tooth replacements can be made out of many materials. It is easier to make it pretty if is made solely of porcelain.
The design and overall strength of these restorations is evolving quickly. At this time, the most common porcelains used as substructures or frameworks are still weaker than metal supported versions. Zirconium bridges are growing in popularity. The dentist and patient must weigh the risks of breakage against the ease of creating an aesthetic result.
2) PFM Bridge: Porcelain supported by a metal substructure
A PFM bridge is the strongest type of dental bridge. Under heavy loads, the top layer of porcelain can chip or fracture off of any bridge. Porcelain is like glass; it has a low tensile strength. When flexed, it will crack, chip, or break. Adding a metallic substructure under the porcelain will reduce flexing under trauma or excessive loads.
If the patient grinds or clenches, it is advisable to support the superficial veneering layer of ceramic with some sort of metal substructure. There are many types of metal substructures which can be added when maximum strength is needed.
The patient rarely is advised of the choices being made on their behalf. These choices determine bio-compatibility, tissue health, and longevity. These metallic substructures are die cast in the lab with various quality levels of metal alloys. A non-precious alloy will not cast as well and will not be as bio-compatible as a high noble alloy with high gold content. Dr. Fondriest always chooses a very bio-compatible “high-noble” precious alloy made primarily of gold.
There are also two more less mainstream types of dental bridges that can be used in certain circumstances
3. Cantilever Bridges
Cantilever bridges are another option for replacing a missing teeth. They are very similar to traditional versions, but the false tooth or pontic is supported by an abutment on only one side, rather than on both sides. So if there’s only one natural tooth or implant next to the gap, a bridge can still be secured. This option is NOT RECOMMENDED for back teeth. This is an option best used for a missing front tooth. The bite forces are less in the front teeth and will be less likely to hurt or dislodge the bridge.
These restorations are only supported on one side. This creates a lever force on the supporting tooth or implant. This may lead to complications like fractured teeth or loosened crowns.
4. Maryland Bridges
A Maryland bridge is a no drill bonded on version. This version consists of a pontic (false tooth) that is held in place by a metal or porcelain framework in the shape of wings projecting on each side of the false tooth. This framework is bonded onto the backs of the two teeth adjacent to the missing tooth. Since this type of restoration isn’t held in place by crowns, the adjacent teeth don’t need to be filed.
A Maryland bridge is used mostly for young adults who have not finished growing and are considered too young for a regular version or an implant. They are used as a temporary solution until adulthood.
While they are more conservative than traditional versions, they do have their downsides. The strength of the bridge is limited by the strength of the resin that holds the wings in place, so it may not stay in place in areas of the mouth where the teeth are subjected to a lot of biting force, like the molars. These are usually only used to replace front teeth.
What does a dental bridge cost?
There are many variables that can affect the price including:
- The number of teeth needed to fill the gap
- The strength of the adjoining abutment teeth
- Which version as described above it is
- Complexity/difficulty of the placement
- Additional treatments for other dental issues, such as the shape of the jaw ridge and the gum health
- The location in the mouth
- Traditional all porcelain or PFM versions typically cost $4,500 – $8,000 for one pontic and a crown for each abutment tooth.
- Bridgework with the ovate pontic design costs more
- Maryland bridges typically cost $1,600 – $2,800 for one pontic with the framework, or wings, attached to the abutment teeth.
- If it is implant-supported then it could cost $5,500 – $15,000 with one or two dental implants spanning three or four teeth.
We invite your to visit the Before and After image section on our site. It has been created to tell the story of each patient featured. There are several before and after dental bridge pictures. The photos have the highest magnification and clarity in the United States and show the craftsmanship of the ceramists.