Replacing missing teeth with a bridge
A dental bridge is commonly used to replace missing or lost teeth. This restoration can appear just like natural teeth. A traditional bridge can be made to appear as though the tooth was never lost. They are done as an alternative to dental implants. Advancements in design techniques have increased the our ability to make it look as though nothing ever happened. Dr. Fondriest works with his favorite ceramist to achieve amazing results.
WHAT IS A DENTAL BRIDGE?
Tooth bridges are used to replace a missing tooth or teeth. When a tooth is missing, the adjacent teeth on either side of the gap are employed to hold a false tooth called a pontic. The supporting teeth are called abutments. The abutment teeth are covered with crowns and these crowns support the false tooth called a pontic.
They are attached to the adjacent teeth or to dental implants next to where the tooth once stood.
The spaces left by missing teeth can cause the adjacent teeth to move or shift. This can result in the bite changing. Bridgework helps prevent this bite collapse from happening.
Dental bridge types
There are four types of dental bridges:
1) All Porcelain Bridge
Permanently cemented types of dental bridges can be made out of many materials. All porcelain versions are easier to make lifelike. The technology behind porcelain bridgework is evolving quickly. There are two main types of ceramics being used today, E max and zirconium. Neither of these are as strong as metal supported versions.
Zirconium bridges are growing in popularity for replacing natural teeth. This is the strongest of the ceramics and the esthetics can be phenomenal.
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 type of bridgework. Porcelain has the same properties as glass. With a a low tensile strength, glass will crack, chip, or break. This bridgework has a metal framework that reduces flexing from chewing and bruxism.
The patient rarely is advised of the choices being made on their behalf. These choices determine bio-compatibility, tissue health, and longevity. The metallic frameworks are created in the lab with different quality levels of metal alloys. A non-precious metal will not fit as well and will not be as bio-compatible as gold. Dr. Fondriest always chooses a very bio-compatible “high noble” precious alloy made primarily of gold.
Both the all porcelain and the PFM versions serve well on implant supported bridges. There are also two more less mainstream types of dental bridges that can be used in certain circumstances
3. Cantilever Bridges
The cantilever version is like 2/3 of a normal bridge. It has a false tooth supported only on one side. The support tooth is called an abutment tooth. It is hanging out in spaces and therefore introduces leverage on the supporting abutment tooth.
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 bridgework.
4. Maryland Dental Bridges
This version has a false tooth supported only by two metal or ceramic wings projecting out from the sides of the false tooth. The wings are fitted to adapt to the backsides of the proximal teeth, also called abutment teeth. At delivery, the wings are bonded to the abutments.
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 as the strength is limited. These are usually only used to replace front teeth.