Missing teeth are replaced with dental bridges, implants, and / or removable partial dentures. Bridgework can be undetectable to the eye. Choosing the best tooth replacement technique 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 extraction
- Gum tissue thickness and continuity of symmetry with the other gum scallops
- Esthetic display of the smile
- Health of the gums
- Budget considerations.
A fixed bridge can be made to appear as though the missing tooth was never lost. Bridgework design has been advancing. We can often make it look as though the tooth wasn’t lost. Dr. Fondriest works with surgical and orthodontic specialists if needed to achieve amazing results.
What is a dental bridge?
A dental bridge is used to cover a space if you’re missing one or more teeth. They are cemented to natural teeth or implants surrounding the space where the tooth once stood. Gaps left by missing teeth can cause the remaining teeth to shift, which can result in a bad bite. Bridges help prevent this from happening.
If you have missing teeth, your dentist can close or bridge the gaps in your smile with dental bridges. A dental bridge has a false tooth (called a pontic) that is held in place by the teeth on either side of the gap. The teeth holding the bridge are called abutment teeth. Bridgework teeth are made the same way as dental crowns.
Types of dental bridges
These tooth replacements are made with different designs and materials. There are two mainstream types of fixed dental bridges:
1) PFM bridgework: Porcelain supported by a metal substructure
Porcelain fused to metal bridges are the most popular type of bridge. They are strong and can be aesthetic. The supporting metal framework under the porcelain reduces flexing under excessive loads. Under unusually heavy loads, veneering porcelain can chip or fracture off of any bridge or crown. Porcelain is like glass; it has a low tensile strength.
The dentist chooses the metal alloy used for the framework. These alloys vary in cost and quality. The patient rarely is advised of the choices being made on their behalf. These choices determine bio-compatibility, tissue health, and longevity of the bridge. A non-precious alloy will not fit as well and is not bio-compatible. Metals with high gold content are the most bio-compatible. Dr. Fondriest always chooses “high-gold” precious alloys.
2) All-Porcelain Dental Bridge
Porcelain bridgework is beautiful and it’s popularity is growing rapidly. It’s easier to make them pretty when the restorations are entirely constructed of porcelain. At this time, all porcelain bridges
are still weaker than versions with metal frameworks. The design and strength of these restorations is evolving quickly. The restorative dentist and patient must weigh the risk of biting forces. These beautiful bridges are not used for bruxers.
There are also two more less mainstream types of bridges that can be used in certain circumstances
3) Cantilever Bridges
Cantilever bridges are similar to traditional bridges. 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 bridge option is NOT RECOMMENDED for back teeth. This is an option best used for a missing front tooth. The bite forces are much diminished in the anterior teeth and will be less likely to damage or dislodge the bridge.
These restorations are only supported on one side. A lever action is applied to the supporting tooth or implant. This can lead to complications such as fractured teeth or loose implants.
4) Maryland Bridges
Maryland bridges are considered a conservative alternative to traditional bridges. The false tooth is held in place by wings projecting on each side of the false tooth. These wings are bonded onto the backs of the two adjacent teeth. Since this type of bridge isn’t held in place by crowns, the adjacent teeth don’t need to be drilled on. This bridge option is used mainly for young adults who have not finished growing and are considered too young yet for a traditional bridge or an implant. Maryland bridges are used as a temporary solution until adulthood.
These conservative bridges, have weaknesses. The strength of the bridge is limited by the strength of the resin that holds the wings in place. They may not stay in place in areas of the mouth where the teeth are subjected to a lot of biting force, like the molars. Maryland bridges are only used to replace front teeth.
What does a fixed 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 teeth
- The type of bridge as described above
- 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 of the bridge in the mouth
- Traditional all porcelain or PFM bridges 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 a one tooth bridge.
- An implant-supported bridge could cost $5,500 – $15,000 for a bridge with one or two dental implants spanning three or four teeth.
Hiding the dark metal margins at the gumline of bridgework
It is rare for Dr. Fondriest not to elect the optional choice of prescribing butt-joint margins. This margin choice covers the metal edges of your bridge with porcelain to prevent the dreaded “black line at gumline“. Most of our PFM bridge versions totally enclose the gold within the ceramic so that the metal is not exposed to the mouth.
We invite you to view some of Dr Fondriest’s cosmetic case results.