Bridges

Dental Bridges

Missing teeth replacement has long been a goal for achieving optimal oral health. Throughout history, various attempts have been made to replace missing teeth, ranging from the ancient Chinese, who carved artificial teeth from bamboo to the ancient Egyptians, who used gold and silver wires to secure artificial teeth.

With the help of recent technological advancements, various tooth replacement options are now available, offering superior aesthetics and functionality. Current tooth replacement solutions include dental bridges and implants

A dental bridge, as its name implies, is a dental prosthesis designed to fill an existing gap. Its stability primarily relies on the adjacent teeth for support. Therefore, during the fabrication of a dental bridge, it is crucial to thoroughly assess the health of the neighbouring teeth to ensure the bridge’s success and longevity.

Why Is It Important to Replace a Missing Tooth?

• Restoring aesthetics: A missing tooth in the smile zone can significantly affect your smile and self-confidence.
• Regain your speech confidence: a missing tooth may affect the pronunciation of certain letters.
• Eating comfortably: A missing tooth can affect your chewing ability, which may limit your food choices and lead to gastrointestinal disturbances due to the inability to chew food adequately.
• Preserve the health of neighbouring teeth: When a tooth is missing, adjacent teeth may tilt to fill the gap, which can negatively impact their periodontal health.
• Maintain a youthful appearance: The teeth and jawbone provide essential support for the facial muscles and lips. If this support is compromised due to missing teeth, it can negatively affect your appearance, potentially resulting in a sunken facial appearance and sagging of the facial muscles.

Dental bridge concept

Dental bridges replace missing teeth with artificial ones that gain support from adjacent teeth. This support can be provided through full-coverage restorations, such as dental crowns in conventional bridges or through a metal plate or wing in a Maryland bridge.

Dental bridges are designed to distribute the forces exerted on the artificial tooth to the adjacent teeth incorporated in the bridge design. This requires a thorough examination of these neighbouring teeth to ensure they can support the bridge without compromising their health.

The prerequisites for a tooth to serve as an abutment for a dental bridge include having a healthy, vital tooth that is free of caries and possesses optimal periodontal health

If the neighbouring tooth exhibits any defects, these must be addressed before incorporating it into the bridge design. A tooth that has undergone root canal treatment should be evaluated for the adequacy of the root canal filling and whether an additional retention post is necessary. A filled tooth must be examined to confirm that the dental filling is intact, healthy, and free from leakage or recurrent caries. Additionally, a tooth affected by periodontal disease should be treated first to ensure it can withstand the forces exerted during function.

Different Designs of Dental Bridges

Conventional Bridge:
It consists of crowns on both sides that cover the teeth adjacent to the edentulous area. These crowns are connected to an artificial tooth.

Cantilever Bridge:
A cantilever bridge is a one-sided attachment bridge through a crown on only one side of the edentulous ridge. The supporting tooth must be strong to bear the entire load alone. This type of bridge is particularly well known for replacing an upper lateral incisor, as the tooth being replaced is small. The bridge is cantilevered onto the adjacent canine, which is one of the strongest teeth in the mouth.

Maryland Bridge:
It is formed of an acrylic base, with attachments to the neighbouring teeth via a metal wing rather than a full-coverage crown bonded to the back surface of the teeth. This type of bridge is primarily used to replace missing anterior teeth, as it lacks the strength to endure the masticatory forces falling on the molar teeth.

Implant-supported
Bridge: This type of bridge utilises dental implants as abutments instead of natural teeth. When multiple teeth are missing, two dental implants are placed on either side of the edentulous area, and a bridge is constructed in between. This approach offers excellent aesthetics, is more conservative as it preserves the natural teeth, and is generally more cost effective than replacing each missing tooth with an individual implant.

Factors Affecting Dental Bridge Design

• Number and distribution of edentulous area
• Length of edentulous span (number of missing teeth)
• Location of missing teeth (anterior or posterior)

• Your expected treatment outcome
• Financial considerations

• Oral hygiene

• Adjacent teeth health

Dental bridge procedure from A to Z

At Dulwich Dental Office, we stay current with the latest technologies and materials to provide our patients with durable restorations. Our expert prosthodontists are skilled in developing treatment plans that consider your individual needs while prioritising the preservation of your dental health. We are the leading dental clinic in London for creating customised, long-lasting dental bridges tailored to your specific condition. The process of constructing a dental bridge includes:

1. Examination of Adjacent Teeth:

Neighbouring tooth health is crucial for designing a durable dental bridge. A comprehensive examination of the teeth adjacent to the edentulous area should assess the compatibility of existing restorations, periodontal health, and any active carious lesions. Any restorative issues in these teeth must be evaluated and addressed before constructing the dental bridge.

2. Dental Bridge Design

The data collected on the number of missing teeth, their locations, and the condition of adjacent teeth, supported by our prosthodontists’ expertise, will be used to determine the most appropriate restorative solution, whether it be a dental implant, removable partial denture, flexible denture, or dental bridge. Your financial capacity and treatment expectations will also be taken into account. When dental bridges are deemed the optimal choice, our prosthodontists will select the most suitable materials and design for the dental bridge.

3. Tooth Preparation and Impression Making

When the dental bridge solution is agreed upon, local anaesthesia is administered to the teeth involved in the dental bridge design. These teeth are prepared by removing a specific amount of tooth structure to create space for the crown coverage. Once the preparation is complete, a shade that matches your natural tooth colour is recorded, and an impression is taken to be sent to the dental lab for the fabrication of the dental bridge.

4. Dental Bridge Cementation

When the dental bridge is finished, our dental experts will first insert it to check for proper fit and colour matching. Once everything is confirmed, our dental professionals will use cement to secure the dental bridge to your teeth. This cementation process makes the dental bridge difficult for you to remove. Any excess cement will be removed, and you will receive detailed instructions on how to maintain your new dental bridge.

Cleaning Dental Bridges

The challenging aspect of cleaning your dental bridge is the small space beneath the artificial tooth. Food particles can become trapped in this area, leading to bacterial buildup, which may result in gum inflammation and cavities in the abutment teeth at the edges of the crowns. Brush and floss your teeth as you normally would, but be sure to add an extra step: clean beneath the artificial tooth of the dental bridge using interdental brushes or a waterpick.