Unlocking the Mystery: What is Bridgework?

April 03, 2024

 Introduction

Ah, the age-old question: What is bridgework? You've probably stumbled across this term while discussing dental health, house renovations, or even civil engineering. But fret not! We're about to dive deep into its most common meaning - the world of dentistry.

What is Bridgework?

Bridgework, in the realm of dentistry, refers to dental restorations used to replace one or several missing teeth by joining permanently adjacent teeth or dental implants. The purpose? Well, not only to fill the void but to keep those pearly whites functioning smoothly.

A dental bridge is a replacement for missing teeth. If any teeth are lost and the gaps present are not occupied with replacement teeth, there is a risk of bone loss, which could impact appearance.

A bridge acts as an anchor for two crowns and consists of a false tooth called a ‘pontic’ which sits between the two crowns. The ‘pontic’ is inserted into the gap made by the missing tooth, and is flanked on either side by the two crowns. The crowns fit over your natural teeth on either side of the gap. The two anchoring teeth are called ‘abutment teeth’.

A bridge can prevent bone loss, gum disease, or decay caused by the presence of food debris in the gap created by the missing tooth, and it will relieve pressure on the teeth on either side of the gap. An enamel-bonded bridge uses a metal or porcelain framework to attach the artificial teeth which are then resin-bonded to the supporting teeth.

If you stick to a healthy oral regime, such as brushing twice a day, flossing, and regular checkups, your bridge can last for up to 15 years.

A dental bridge can give you a natural-looking appearance as well as resolve any ‘bite’ problems that you may have. But be aware, it can cause your teeth to feel a bit sensitive for the first few weeks after it has been fitted.

Why Bother with Bridgework?

Let's face it, a missing tooth can throw a wrench in the works when it comes to chewing, speaking, or even just flashing a confident smile. Aside from the aesthetics:

1. Prevents Teeth Drifting: Ever heard the phrase, nature abhors a vacuum? In the absence of a tooth, adjacent ones may start to drift into the space.
2. Maintains Face Structure: Believe it or not, teeth play a huge role in maintaining our facial structure.
3. Avoids Bite and Jaw Issues: Bridgework can help maintain the integrity of your bite, preventing potential jaw issues down the road.

Indications of Bridge 

1. In short edentulous spaces 

2. Abutment teeth and supporting tissues are healthy 

3. To harmonize dental occlusion in temporomandibular joint 

4. To stabilize and splint the dentition after advanced periodontal therapy 

5. When the patient desires a fixed prosthesis

6. The patient has the skills and the motivation to maintain good oral and prosthetic hygiene 

7. When the removable prosthesis is not indicated as in mentally and physically challenged patients 

Contraindications of Bridge 

1.1. Edentulous space with no distal abutment.

2. Long edentulous spaces.

3. Bilateral edentulous spaces with more than two teeth missing on either side require cross-arch stabilization.

4. Presence of periodontally weakened abutments.

5. Teeth with very short clinical crowns like congenitally malformed teeth.

6. Severe loss of tissue in the edentulous ridge because of surgery or trauma.

7. The patient has poor oral hygiene.

8. Very young patients with wide pulp chambers.

9. Very old patients, because of brittle teeth.

10. Medically compromised patients.

 

Types of Bridgework

Ahoy there! Are you ready to navigate the sea of options? Here we go:

• Traditional Bridges: These involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic (fake tooth) in between. The traditional bridge is the most common type of bridge. This bridge is used where there are one or more healthy teeth present on both sides of the missing tooth. The enamel of these teeth will be filled down and a crown will be used to cover them. The bridge is a single extensive structure that is typically made from porcelain and fits snugly between the teeth. 
• Cantilever Bridges: Used when there are adjacent teeth on only one side of the missing tooth or teeth. The process entails filing down the enamel layer of the natural tooth and covering it with a crown that is connected to a pontic. Like the regular bridge, the bridge will cover the gap. This bridge is not usually recommended for restoring lost back teeth where there is a lot of chewing force generated that can damage it. They are not as common as the other types of dental bridges. Bit of a balancing act!
• Maryland Bonded Bridges: These are made of porcelain, porcelain fused to metal, or plastic teeth and gums supported by a metal framework. The Maryland Bridge is more conservative. it is known as a resin-bonded or adhesive bridge, the pontics can be made of a porcelain framework. The framework is then connected to the teeth located close to the gap. It is an excellent option if the patient does not want to have any of their healthy teeth modified for dental crowns. 
• Implant Supported Bridge : An implant bridge has a similar structure as the traditional dental bridge but is supported by dental implants, instead of natural teeth. This option can be used to replace three to six missing teeth. Two implants are placed in the jawbone on the two sides of the gap and a crown is attached, then the bridgework is between them. It is typically more stable and comfortable than the other dental bridge options.

Bridgework vs. Implants: Which to Choose?

Good question! Both have their perks.

1. Longevity: Dental implants might win the long game as they can last a lifetime with proper care.
2. Natural Feel: Many find implants to feel more like their natural teeth.
3. Maintenance: Bridgework might need more frequent check-ups.

That said, bridgework is often less invasive and can be a quicker solution.

Many dental insurance plans cover bridges and many now cover implants as well. a dental bridge may need to be replaced every 5 to 15 years, depending on proper care while implants are considered a permanent solution. Some factors can reduce the life of all types of bridges, including implants, such as dental hygiene .

What About the Cost?

Well, here's the tooth of the matter! Bridgework, on average, can be less expensive than dental implants. However, factors like the number of missing teeth, materials used, and location can play a part.

Caring for Your Bridgework

So, you've taken the plunge. Now what?

• Brush and Floss Regularly: Yes, just like your natural teeth!
• Avoid Hard Foods: Think twice before diving into that jawbreaker.
• Regular Dental Check-ups: Always a smart move.

Possible Complications?

Well, no sugar-coating it. Just like any dental procedure, there could be hiccups. Such as:

• Tooth Sensitivity: Especially to hot and cold.
• Pain: Could occur but usually subsides.
• Loose Bridge: It happens! But can be fixed.

Bridgeworks usually fail due to decay or leakage under the crowns on the supporting or 'abutment' teeth or sometimes due to fracture of one or more of the abutment teeth. If this can be successfully treated and the teeth remain maintainable, new bridgework can be made. 

Advantages of Bridge 

1. Aesthetics 

2. Patient feels more secure than with a Removable denture

3. Capable of directing forces along the axis of the tooth.

4. Superior strength.

5. Provide proper occlusal function.

6. Maintain arch integrity/tooth position.

7. Maintain occlusal relationships.

8. Protect and preserve the remaining structures

Disadvantages Of Bridge

1. Involves irreversible preparation of abutment teeth.

2. Abutments susceptible to recurrent decay.

3. Preparation may injure pulp and periodontium.

4. Cost for a remake if it needs to be replaced.

5. The creation of diastema is difficult.

 

FAQs

1. Do bridges look natural? Absolutely! With advances in dental technology, they can seamlessly blend with your natural teeth.
2. How long does bridgework last? With proper care, 10-15 years isn't out of the question.
3. Can you eat normally with a dental bridge? Yup! But give it some time after the procedure.
4. Does insurance cover bridgework? Often, they do, at least partially. But check with your provider!
5. Is the procedure painful? Pain is subjective, but local anesthesia is used to ensure comfort.
6. Can bridges be whitened? Nope! So, select a shade you're happy with from the get-go.

External Resources

For a deeper dive, consider checking out:

• American Dental Association
• Wikipedia’s page on Dental Bridges

Conclusion

So, there you have it! The ins and outs of bridgework in the world of dentistry. Whether you're considering it for aesthetic reasons or functionality, it's a tried and true solution. Remember, as with anything, knowledge is power. So keep those questions coming, and keep smiling!

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