Types of dental bridges

One of the solutions for replacing missing teeth is a dental bridge. A dental bridge is placed where the missing gap is filled with a false tooth or teeth and is anchored by your original teeth on each side of the gap. Dental bridges can be made of gold, metal alloy, porcelain ceramic or a combination of materials.

There are many reasons why one might consider getting a dental bridge beside improvement in cosmetic appearance. If you don’t replace missing teeth, you risk your current teeth shifting to fill the empty gap. This can cause a misalignment in your bite, which can in turn impact the health of your remaining teeth, your gums, and strain your jaw joint. You may also have difficulty chewing and pronouncing certain sounds. A dental bridge can improve your bite strength and chewing, prevent tooth alignment issues, as well as restore speech and pronunciation.

To determine if you are a good candidate for a dental bridge and what type of bridge will fit your needs, schedule an oral exam with your dentist. Your dentist performs a careful exam and develops a treatment plan. It is likely that dental images (x-rays) will be taken to help the dentist visualize the condition of the surrounding teeth and supporting bone. The teeth on each side of the missing gap will be evaluated to make sure they can support a dental bridge.

In this post, we will explore and learn more about the differences between the 4 main types of dental bridges. Let’s dive in.

What are the different types of dental bridges?

Traditional
Maryland
Implant-Supported
Cantilever

Traditional dental bridge

Traditional bridges are the most common type of dental bridge. A false tooth (called a pontic) is placed in the missing gap and is supported by dental crowns placed on the teeth on either side of the gap (called abutment teeth). The teeth on both sides must be healthy and will have to be modified in order to support the dental bridge.

Advantages of a traditional bridge includes:

Are cemented in place and are not removable
They are stable, esthetic, comfortable, and long-lasting if good oral hygiene is maintained
Restores your typical bite force, which makes functions, such as chewing, easier
Keeps the teeth above and around the missing tooth/teeth from shifting

Disadvantages include:

The enamel on the abutment teeth needs to be removed and crowns made for these teeth to support the missing tooth replacement
It can be more difficult to clean around the bridge than it was with your natural teeth
The teeth under the crowns are still susceptible to tooth decay and require excellent daily hygiene to make sure your teeth stay in healthy condition

Maryland dental bridge

A Maryland Bridge (named for the University of Maryland team that designed them), also known as a Maryland Bonded Bridge, uses a false tooth with a wing-like metal or porcelain framework that is bonded with a special cement onto the backs of the supporting abutment teeth. It is similar to a traditional bridge in that you need healthy, natural teeth on each side of the missing gap in order for the Maryland Bridge to be installed. What sets it apart though and is a major perk is that your natural teeth need none or only minimal alteration. Maryland Bridges are also more affordable and take less time to design than a traditional bridge.

However, Maryland Bridges are not a good option for use on back teeth or for those with bite issues. There is also a risk for the metal frameworks to cause the bonded teeth to appear slightly discolored. Maryland Bridges also have a tendency to debond or work loose over time. They are usually only recommended for single tooth replacement in low stress situations with missing front teeth. They may also be used as a temporary replacement appliance while a jaw implant site is healing or for those who are under 18 years old and are waiting for their growth cycle to complete for a more permanent implant supported crown installation.

Implant-supported dental bridge

An implant-supported bridge can be used for those who don’t have natural teeth on both sides of the missing tooth/teeth that can support the false tooth, or when there are large gaps with multiple missing teeth and not enough support available from remaining natural teeth. Implants are placed in the jawbone to simulate tooth roots and crowns fabricated to place on these implants, These are used instead of natural tooth crowns to keep the false tooth or teeth in place. There are many benefits to implant-supported bridges, mainly they are strong and durable and usually don’t involve cutting down and placing crowns on natural teeth.

However, it’s important to be aware that having an implant-supported bridge is a more involved and expensive process and typically requires two surgeries:

Surgery 1- sets the implants into the jawbone
Surgery 2 – uncover the implant and position the bridge abutments and crowns

If you don’t have adequate bone mass in your jaw this surgery may not be for you (although bone grafting can often supply the needed bone mass). Some potential complications of an implant-supported bridge are infection, nerve damage, inflammation and bone loss around the implants and implant failure. These complications can usually be avoided with careful planning, an easy-to-clean implant-supported bridge, and a good long-term dental hygiene and professional follow-up routine.

Cantilever dental bridge

A cantilever dental bridge, is unique in that it only needs a single natural abutment tooth to secure false replacement tooth crown in place. In other words, you only need one strong natural tooth to fill in the missing gap.

Cantilever bridges work best for those who are only missing one tooth in a low stress area, usually a front tooth. As with a traditional bridge, the tooth on one side of the missing tooth is prepared for a crown and the false tooth is attached to this crown. Cantilever bridges are best placed in the front of the mouth because if it’s placed in the back, they can put too much stress on one tooth.

The advantages and disadvantages are similar to the traditional bridge with the exception that the cantilever has more limited application because of its stress bearing limitations.

Final thoughts

Dental bridges can help save your smile and have numerous benefits and can even fix problems caused by missing teeth, which include preventing alteration of your face shape, re-adjusting your bite, and making sure your remaining teeth stay in position. Decisions about how to replace missing teeth requires consideration of many factors including the patient’s desires, cost, the general state of the person's oral health, characteristics of the jawbone and gums, and health of the remaining teeth.

The good news is that all these types of dental bridges have a high rate of success when placed in the appropriate situation and when good oral hygiene is maintained. If you have any questions about whether or not you need a dental bridge, and what your various options are, find a dentist using our directory.

Sources

^{1. Frothingham, S. Dental Bridge: 4 Types, Benefits, Use Case and Costs. (2018) from https://www.healthline.com/health/dental-bridge}

^{2. Bridges. (n.d.) from https://www.mouthhealthy.org/en/az-topics/b/bridges}