When an adult loses is missing a tooth or several teeth, a bridge is a good alternative to replace the missing tooth. The missing tooth should have at least one tooth on either side of it.
For one missing tooth, at least one (retainer) tooth on each side of the space is trimmed down to receive a crown. The walls of the trimmed teeth should be almost parallel with only a mild taper. Two crowns are then made and are separated and attached to a fake crown between them. This fake crown is called a pontic. The one-piece three-unit bridge is then cemented permanently on the patient's prepared teeth.
To replace two missing teeth, one or two teeth on each side of the missing tooth must be trimmed to receive crowns.
Abutment teeth should be free of periodontal disease (non-mobile and no deep gum pockets).
A bridge generally involves at least 3 dental appointments.
At the first dental appointment, abutment teeth are assessed. A shade or color of the new bridge will be selected. Study impression molds and temporary impression molds are made. (Sometimes, study impression molds are used to create diagnostic wax-ups). In the dental laboratory, the temporary impression mold has a plastic tooth added to the missing tooth space, and a small mold is taken of the repaired bridge area of the larger mold. The dentist will use this “temporary smaller mold” to create the temporary bridge.
At the second dental appointment, the dentist will “freeze” the patient. After the patient is well anaesthetized, the dentist will trim the abutment teeth. A precisely accurate mold is then taken of the prepared teeth and this mold is sent to the commercial dental laboratory for fabrication of the new permanent bridge. The patient is not sent home with the trimmed teeth exposed. The dentist will use the “temporary smaller mold” to create a temporary bridge using tooth colored acrylic resin. This temporary bridge will be cemented temporarily on the trimmed abutment teeth with soft cement and it actually repairs and replaces the missing tooth while the permanent bridge is fabricated.
At the third dental appointment, the patient may or may not be “frozen”. The temporary bridge is teased off the abutment teeth and the new permanent bridge is tried in and evaluated for fit, bite and appearance. It is then cemented with a hard permanent cement.
Different types of bridges include:
Full Porcelain (all ceramic) bridge
- Newer porcelain bridge maded with zirconia substructure with porcelain added.
- Excellent esthetics and translucency
Porcelain Fused to metal bridge
- Metal substructure with porcelain added
- high fracture resistance
- sometimes unesthetic if recession occurs
5 unit bridge from the back
bridge from the front
seating bridge on the prepared teeth
5 unit bridge seated on the model