A bridge, by definition, is a structure that spans a space and is supported by a number of abutments. In comparison, a dental bridge is a restoration that spans an edentulous space (an area of missing teeth) and is supported by either teeth or implants. When done properly, the bridge should be both aesthetic and functional. Just as important is the ability to maintain the bridge through brushing and flossing. As with crowns, bridges can be fabricated of ceramic, ceramic and metal or just metal. Due to the possibility of an allergic reaction, crowns and bridges containing metal should only be fabricated of High Noble Gold alloys. What Types of Bridges Are Available?
Traditional bridges involve preparing a tooth or teeth (depending on the length of the bridge) on either side of the edentulous space. The preparation is similar to that of a crown. The crowns that replace the missing dentition are referred to as pontics.
Cantilever bridges are fabricated when there are no supporting teeth at one end of the edentulous space. The cantilever bridge should be carefully considered due to their unilateral support and should be limited in length.
Maryland bridges or resin-bonded bridges are designed to be minimally invasive and preserve tooth structure. They are usually comprised of the pontic tooth and two wings at either end of the pontic which are intended to be bonded to the abutment teeth. They too, should be considered carefully due to the possible lack of retention due to the minimal preparation.
How Is The Procedure Done?
As with all dental procedures, planning is the most important first step. Understanding what the patient and doctor expect as a final outcome will determine the extent of the preparation, the fabrication type and shade or color of the final prosthesis. In general, the supporting teeth and or abutments are prepared or miniaturized to accommodate the proper amount of material needed to fabricate the bridge with natural contours and without interfering with the bite or occlusion. A provisional restoration is fabricated and placed to restore the dentition during the time that the final prosthesis is being fabricated. In certain circumstances, the provisional restoration, is kept in place for a longer period of time. This may be done to allow tissues to heal post periodontal surgery, to refine aesthetics or to refine an individual’s occlusion. Prior to fabrication, an impression must be taken to provide the laboratory with a model on which to fabricate the bridge.
At the delivery appointment, the bridge will be checked for proper fit by the dentist and adjusted as needed. The patient should have the opportunity to visualize the bridge and make a request for changes as needed prior to the cementation of the bridge. Once the patient is satisfied with both the form and fit of the bridge, the bridge will be either cemented or bonded to the abutment teeth. The patient should advise the dentist immediately if the patient has any difficulty with the bridge.