Traditionally, a bridge is fixed to adjacent teeth and depends on those teeth for support.
A bridge is a possible treatment option where there is one or more teeth missing leaving a small/medium sized gap and the adjacent teeth are strong and have good bone support.
Before implants were available, bridges were the only fixed solution to replace teeth. Today, implants are generally the treatment of choice in most cases unless implant treatment is not straightforward or the patient does not want to have implant surgery.
Bridges are fixed prosthesis shaped like teeth. They can look and feel very natural. There is no surgery required, and the treatment time is shorter than for an implant. They are also usually cheaper than implants.
Teeth underneath the bridge can also decay if they are not adequately cleaned every day.
Another potential problem is fracture or chipping of the ceramic that overlays the bridge. This is more common in posterior teeth or in patients that clench/grind their teeth.
There are two main types of teeth supported bridges
- Conventional bridge
- Adhesive bridge
For conventional bridges, the adjacent teeth are reduced in size so that they can be crowned. The false tooth (pontic) is fixed to the crowns.
Though stronger and less likely to de-bond than an adhesive bridge, conventional bridges require drilling of adjacent teeth. Because the supporting teeth have to be prepared parallel to each other more tooth is often removed than if a crown alone was to be placed. Research shows that a relatively common complication of preparing teeth for bridges is pulp death. As a result, supporting teeth may require root canal treatment at some stage in the future.
An adhesive bridge involves fixing a false tooth to the adjacent tooth or teeth using metal wings that are bonded on to the back of these teeth.
The main advantage of adhesive bridges is that little or often no tooth preparation of the adjacent teeth is required. As a result, the treatment may be considered a reversible treatment option especially when weaker cements are used.
The main disadvantage of an adhesive bridge is that it may occasionally debond. This means that there may be a chance that the bridge becomes uncemented and dislodges from the adjacent teeth. Although the bridge can be recemented this may cause inconvenience.