Bridges – replacements for missing teeth
Usually, bridges are fixed dental prostheses for bridging one or more gaps between teeth. This means that not only is chewing functionality fully restored, but an aesthetically-pleasing overall appearance is also achieved. Other advantages of bridges are their durability and comparatively low cost.
The standard solution for a missing tooth is a fixed-base bridge. It is supported by neighbouring teeth, which are converted into bridge abutments and then crowned. To do this, however, they first have to be ground down, which usually means that healthy tooth substance is lost (this is the main disadvantage of bridges). There is less of a need to do this if the neighbouring teeth are decayed. In the case of a base bridge, the pontic (i.e. the replaced tooth) usually rests directly on the alveolar ridge. However, there are also so-called floating bridges where the pontic does not touch the mucosa itself, but spans an arch over the gap. This makes cleaning easier, as the bridge can be rinsed underneath. However, because of the aesthetic impact, floating bridges are only used in the back molar region.
If a healthy tooth suitable for an abutment is only available on one side of the gap – or if it would entail losing a disproportionate amount of healthy substance to grind down the tooth on the other side as well – then a free-end bridge is also a possibility. It is fixed on one side only, but usually on two adjacent teeth; otherwise the statics would be compromised. In any case, a free-end bridge cannot be subjected to as much stress as a standard bridge, which is why it is only used for fairly small tooth gaps.
Adhesive, composite and telescopic bridges
The range of bridges available today is by no means exhausted. Bridges can also be attached to neighbouring teeth using adhesive. The advantage of these adhesive bridges is obvious: The abutment teeth do not have to be ground down. The prerequisite, of course, is that they are healthy and resilient in terms of adhesive use. Even then, however, adhesive bridges cannot withstand comparable loads to standard bridges, which is why they are not very suitable for the molar region. They are primarily suitable for children and adolescents who require a certain degree of flexibility for unimpeded further growth. Adhesive attachments are a variant of adhesive bridges: to attach them, small wings with hinges are glued to the adjacent teeth. The denture can then simply be pushed into the hinge, leaving it securely positioned.
Hybrid or composite bridges are bridges that connect different types of abutments. Usually, one side rests on a dental crown and the other on an implant. Alternatively, the term is also used for bridges that combine different materials. Generally, the same materials used for crowns are used for bridges – i.e. metal (mainly gold) and ceramic.
If there are only a few healthy teeth left, a telescopic bridge may be advisable. It is not cemented or glued, but instead attached to crowns (so-called inner telescopes). The precisely-fitting outer telescopes are located in the bridge. Telescopic bridges offer the advantage that they can be removed for cleaning, just like a removable denture. However, patients can also choose to leave them in the mouth permanently.
This overview shows that there are a variety of options for remedial bridges. In many cases, however, implants are the superior solution. We will be happy to advise you in detail about your options.