A dental bridge is a common, affordable, time-tested, and low-risk treatment for missing teeth. The dental bridge is so called because it literally bridges the gap created when teeth are lost. The typical bridge comprises one or more artificial teeth, known as pontics, which are held in place by two dental crowns, or abutments. Though the replacement teeth used in bridges can be made from a variety of materials, including silver amalgam or gold, they are commonly made from porcelain for aesthetic considerations.
To place a traditional bridge, a dentist will secure the crowns to the teeth on either side of a gap, anchoring the pontic or pontics so that they fill the space. The result is a smile that is fully restored in terms of function and appearance.
However, bridges can also be attached to dental implants, which do not rely on natural teeth for support. To affix this type of restoration, a dentist will surgically embed tiny biocompatible posts made of titanium in a patient’s jawbone, and these posts secure the entire restoration. Dental implants are the only dental restorations that mimic the entire structure of missing teeth, including the roots, making them the strongest, most stable method of securing bridges available.
No matter what type of bridge a patient receives, the restoration will have significant aesthetic and practical benefits. The new teeth will restore dental functionality and oral health. Additionally, thanks to new dental technology and aesthetic advances, today’s dental bridges are virtually indistinguishable from natural teeth.
Traditional bridges are supported by two crowns on either side of the gap in a patient’s smile. Typically, these crowns will go directly on top of a patient’s adjacent teeth. To place this type of restoration, the dentist will need to reshape the nearby teeth to make room for the bridge. In the last 20 years, implant-supported bridges have become increasingly popular. These bridges also rest on two crowns, but the crowns top surgically placed implant posts, rather than the nearby teeth. Using this type of restoration, a dentist can preserve more of a patient’s natural tooth structure.
To place a cantilever bridge, the dentist will only crown one adjacent tooth. This single crown will support the entire restoration, which typically consists of two pontics. Dentists do not typically recommend cantilever bridges on back teeth. The molars bear most of the force of a patient’s bite. Therefore, a cantilever bridge in this area would be subject to damage and even collapse. Cantilever bridges have largely fallen out of use. However, in some cases, they can still be an excellent option, since they will preserve more of a patient’s healthy tooth structure.
The Maryland bonded bridge, developed by researchers at the University of Maryland, involves minimal alteration of the surrounding teeth. Instead, the pontic will have two small wings, which will attach to the adjacent teeth. To place this type of bridge, the dentist will simply need to micro-etch the two supporting teeth to create a stronger bond for the restoration. In the past, the wings were always made of metal, which could eventually lend a gray tint to a patient’s smile. Today, however, Maryland bonded bridges are made with resin wings. These pieces can be custom-matched to the blend with the color of the nearby teeth. Typically, dentists will use a Maryland bonded bridge to replace a single missing tooth. In some cases, however, these bridges can replace two or three teeth.
Although most bridges are permanently fixed in a patient’s mouth, some people may benefit from a removable bridge, sometimes called a “partial denture.” Like traditional bridges, removable restorations are custom crafted to match a patient’s natural teeth. However, they have a gum colored plastic base and attach to the surrounding teeth with small metal clasps or precision attachments. Removable bridges typically cost less than crown or implant-supported restorations. Nevertheless, they do not offer the same stability or lifelike feel that a fixed bridge can provide.