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Dental bridges are popular options for permanent tooth replacement and are used in a variety of situations. In this article, we take a look at the most popular techniques being used as well as some of their advantages and disadvantages.

People will often hear the term "bridge" when talking about permanent tooth replacement with their dentist. It is a tried and trusted approach to replace multiple teeth through the support of other anchoring teeth.

Traditionally, a bridge has meant that the prosthesis will be fabricated on supporting teeth on either side but implant-supported bridges have also become extremely popular nowadays. There are a number of different techniques that the dentist can use to design this bridge.

Tooth-Supported Dental Bridge

Think of the kind of bridge that you see in the cities around you. It requires the presence of sturdy pillars on either side and maybe in the middle as well. This exact same principle applies to the design of the dental bridge [1].

Ideally, the doctor would like to have the same number of teeth providing support to the bridge as the number of missing teeth. Such bridges work best in situations where a couple of teeth have to be extracted because they were decayed or fractured. The surrounding teeth will be well supported by the jaw bone and in turn will be able to provide a good base for the crown to be formed [2].

The advantage of this technique is that it is easy and can be performed by almost any kind of dentist. It has been around for a long time and functions well up until the supporting teeth are healthy [3].

The drawback of this technique is that it requires some healthy teeth to be ground down for no reason but to provide support to the bridge. This can lead to the need for root canal treatment in the future because of the development of pain and sensitivity [4].

Another big drawback for this type of prosthesis is the fact that in gum disease, it is highly likely that bone loss will affect multiple teeth in the area. Thus, missing teeth will be more difficult to replace through the fabrication of a bridge as the supporting teeth will not be able to bear the additional load [5].

Implant-Supported Bridge

For patients who do not have enough supporting teeth or maybe no teeth at all, the option of an implant supported bridge is like a godsend. The basic idea here is exactly the same as a traditional tooth supported bridge but with implants instead of teeth [6].

By placing enough implants to be able to support long-span bridges, dentists are now able to replace the entire dentition of patients with relative ease [7]. The additional advantage of this method is that the length and width of the implants are in the dentist's hands and so by increasing any one of the parameters the amount of support derived from the implant can be magnified greatly.

This principle has allowed concepts like all-on-four, where only four long and angular implants are used to provide the support for an entire jaw [8].

The drawback of implant-supported bridges is their high cost, invasive nature of treatment, and their susceptibility to the same kind of micro-organisms that cause gum disease.

It is incumbent on the patient to be able to maintain good oral hygiene and to visit the dentist for regular checkups once an implant supported bridge has been placed in the mouth [9].

Maryland Bridge

This is a specific kind of bridge usually used in the front region of the mouth. The bridge is also most often limited to one to two teeth being replaced. This kind of bridge is very conservative and does not require the surrounding teeth to be ground down.

The bridge actually has two wings that take support from the back of the supporting teeth.

This conservative design makes it ideal for use in temporary situations up until the final prosthesis can be placed but comes at a cost as well. A Maryland bridge does not have the same kind of retention that a normal bridge would have and thus keeps coming off. It has to be replaced by the dentist every time it comes off as well making the process somewhat cumbersome for the patient [10].

Some dentists do end up using a Maryland bridge as a permanent solution as well but that is not something that we are big fans of.

Conclusion

Permanent replacement of teeth through different techniques used for dental bridges depends upon the unique clinical situations that patients come with. The individual experience and treatment philosophy of the dentist will also play a huge part in the eventual choice being made. Irrespective of the exact path decided on, though, bridges have proven themselves as an excellent, long-term solution, for hundreds of thousands of patients worldwide.

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