Dental Bridge

What Is a Dental Bridge?

A dental bridge closes the gap left by one or more missing teeth with a fixed restoration. The name describes the structure: the teeth on either side of the gap are the supports, and the false tooth in between is the span. The supporting teeth receive crowns, and the false tooth is made in one piece with those crowns and cemented onto the teeth. You do not take a bridge out yourself, so cleaning and check-ups are planned around that.

A bridge is not a crown. A crown covers a single tooth; a bridge links several crowns and the false tooth between them. Nor is a bridge a material. The same bridge can be made in zirconia, porcelain fused to metal or an all-ceramic such as E-max; each material is described on its own page, and how it behaves as a bridge is covered here.

There are several types. A conventional bridge is held by the teeth on both sides of the gap. A cantilever bridge is held on one side only. A Maryland bridge carries the false tooth on thin wings bonded to the back of the neighbouring teeth, so very little of those teeth is removed. An implant-supported bridge sits on implants instead of natural teeth. Which type fits depends on the supporting teeth, the length of the gap and your bite.

Who Is a Dental Bridge For?

A bridge is considered when one or more teeth are missing and the teeth on either side have sound roots, healthy gums and good bone support. If those teeth already carry large fillings, are cracked or have had root canal treatment and need crowns anyway, the bridge protects them at the same time. It also offers a fixed option when implants are not suitable for health reasons or when you would rather avoid surgery.

There are cases where a bridge is not the right choice. If the supporting teeth have short roots, have lost bone support through gum disease or are loose, a bridge puts too much load on them. If the gap is long, the span between the supports lengthens and the bridge becomes weaker. If the neighbouring teeth are completely sound, an implant or a bonded bridge is discussed instead of reducing those teeth just to carry a bridge.

Cost and survival bring the two routes close together. A systematic review comparing a single implant crown with a conventional bridge for one missing tooth found similar initial costs and similar failure rates, and concluded that the benefit of keeping healthy neighbouring teeth untouched makes the implant crown more economic for the patient (PubMed 23062127). The decision therefore rests on the neighbouring teeth as much as on price. A fuller comparison is in dental implant vs dental bridge.

How Is a Dental Bridge Made?

Treatment starts with an examination and X-rays. The roots, bone support and gum health of the supporting teeth are assessed, and any decay, root canal or gum problem is treated before the bridge. The bridge type, the number of units and the material are set from these findings, and at Mosdent they are written into your plan after the examination.

For a conventional bridge the supporting teeth are reduced to make room for crowns. This is the most debated part of a bridge. Measured on front teeth, all-ceramic and metal-ceramic crown preparations removed about 63% to 72% of the tooth crown, while veneer and resin-bonded retainer preparations removed about 3% to 30% (PubMed 12070513). On back teeth, full crown preparation removed 67.5% to 75.6% of the tooth structure (PubMed 12186346).

Once the teeth are prepared, an impression or intraoral scan is taken and a temporary bridge protects the teeth while the laboratory makes the final one. The final bridge is tried in; after the fit, shade and bite have been checked, it is cemented permanently. For a Maryland bridge only the back surface of the neighbouring tooth is lightly prepared and the wing is bonded to it. For an implant-supported bridge the impression is taken from the implants and the bridge is screwed or cemented onto them.

Treatment Process

1. 01Examination and X-ray: The roots, gums and bone around the supporting teeth are assessed; root canal or gum treatment comes first if needed.
2. 02Tooth Preparation: The supporting teeth are reduced to make room for crowns, an impression or intraoral scan is taken and a temporary bridge is fitted.
3. 03Try-in: The fit, shade and bite of the laboratory-made bridge are checked in the mouth.
4. 04Fitting: The bridge is cemented permanently; an implant-supported bridge is screwed or cemented in place.
5. 05Check-ups: The area under the bridge and the edges of the supporting teeth are checked regularly for decay and gum health.

How Long Does Treatment Take?

The timeline depends on the bridge type and on how much preparation the supporting teeth need, so it is listed as case-dependent. A conventional bridge needs at least two appointments: the first to prepare the teeth, take the impression and fit a temporary bridge, the second to try in and cement the final bridge. The time in between is laboratory time and varies with the material.

Some situations extend the plan. If a supporting tooth needs root canal treatment, that comes first. If a tooth has just been extracted, the site is allowed to heal; a bridge fitted straight after an extraction can leave a gap under it as the gum and bone shrink over time. A temporary bridge or denture can be worn during that period.

With an implant-supported bridge, the timeline follows bone integration. Under conventional loading, implants are kept free of load for 3 to 8 months (PubMed 23543525). Once integration is confirmed on an X-ray, records are taken for the bridge.

Getting a Dental Bridge in Turkey

If you are travelling for treatment, plan for two visits to the clinic within one stay for a conventional bridge, with laboratory days in between, and longer if a supporting tooth needs root canal treatment first. An implant-supported bridge usually means two trips, because the implants need months to integrate before the bridge is made. The number of appointments and days for your case is set at the first examination and written into your plan, together with how follow-up works once you are home. The cost section on this page lists the unit prices from the clinic's price list.

How Long Does a Dental Bridge Last?

Conventional bridges have been followed over a decade. In the meta-analysis by Tan and colleagues pooling 19 studies with at least 5 years of follow-up, 10-year survival was 89.1% and 71.1% of bridges stayed free of any complication (PubMed 15533126). The same study put the 10-year risk of losing a bridge to decay at 2.6% and to gum disease at 0.7% (PubMed 15533126).

The type of bridge changes the outcome. A meta-analysis comparing bridge types found 5-year survival of 93.8% for conventional bridges, 91.4% for cantilever bridges and 95.2% for bridges on implants alone, falling to 89.2%, 80.3% and 86.7% at 10 years (PubMed 17594374). In the same study, the share of patients with a complication at 5 years was 15.7% for conventional bridges, 20.6% for cantilever bridges and 38.7% for implant-supported bridges.

A separate meta-analysis of cantilever bridges, covering 13 studies, found 10-year survival of 81.8%, with 63% free of any complication (PubMed 15533127). The authors noted that cantilever bridges did worse than conventional bridges supported on both sides.

For Maryland bridges, a meta-analysis of 29 studies and 2,300 resin-bonded bridges reported survival of 91.4% at 5 years and 82.9% at 10 years (PubMed 28191679). These averages do not promise an individual result; oral hygiene, check-ups and bite load decide it.

Bridge Types and Materials

The conventional bridge is the most common type and takes support from both sides. A cantilever bridge is supported on one side only and carries load like a lever; a comparative review recommends it as a second option, for anatomical or patient-related reasons (PubMed 17594374). A Maryland bridge is mostly used for a single missing front tooth; the details are in Maryland bridge.

Design matters for bonded bridges. The same meta-analysis found significantly higher survival for resin-bonded bridges with a zirconia framework and with one wing, and higher survival at the front of the mouth than at the back (PubMed 28191679). An implant-supported bridge replaces several missing teeth without touching natural teeth; when every tooth in a jaw is missing, that plan is described under full mouth dental implants.

Material behaves differently in a bridge than in a single crown. In a meta-analysis of 41 studies on tooth-supported bridges, 5-year survival was 92.9% for veneered zirconia, 91.3% for metal-ceramic, 87.9% for monolithic zirconia and 82.5% for lithium disilicate, and only the lithium disilicate difference was significant (PubMed 41650383). The authors conclude that weaker ceramics are unsuitable for multi-unit bridges and that monolithic zirconia resists fracture better. Zirconia bridges are covered in zirconia bridge, and longer spans in 5-tooth bridge.

Risks and Limitations

The most frequent problems with a bridge appear in the supporting teeth. For conventional bridges, the most frequent complications are biological ones such as decay and loss of pulp vitality in the supporting teeth (PubMed 17594374). In cantilever bridges, loss of pulp vitality occurred in 32.6% and decay at the supporting teeth in 9.1% over 10 years (PubMed 15533127). That is why the edges and underside of the bridge are checked closely at every visit.

A bridge coming loose or breaking are the technical problems. For conventional bridges, the 10-year risk was 6.4% for loss of retention, 2.1% for fracture of a supporting tooth and 3.2% for material fracture (PubMed 15533126). In resin-bonded bridges, de-bonding was the most common problem at 15%, followed by chipping of the veneering material at 4.1% (PubMed 28191679). A bridge that comes loose can often be re-cemented, but any decay underneath is treated first.

Material brings its own risks. In tooth-supported bridges, decay at the supporting teeth and loss of retention were more frequent with zirconia frameworks than with metal-ceramic bridges (PubMed 25935732). In implant-supported bridges, 4.1% of veneered zirconia bridges were lost to ceramic fractures against 0.2% of metal-ceramic bridges (PubMed 30328185).

A bridge is a lasting decision: a tooth reduced for a conventional bridge does not return to its original shape. That limit is why other options are discussed when the neighbouring teeth are sound.

Aftercare

The area under the bridge, where the false tooth meets the gum, cannot be cleaned with a normal toothbrush. Special floss that threads under the bridge, interdental brushes or a water flosser are used, and which one suits your bridge is chosen together once it is fitted. The crown edges on the supporting teeth are where decay most often starts, so daily cleaning pays particular attention to them.

At check-ups the edges and underside of the bridge, gum health and the bite are examined, with X-rays when needed. Regular professional cleaning stops plaque under the bridge from turning into gum disease. If you notice the bridge moving, a bad smell, sensitivity or pain in a supporting tooth, come in without waiting for the next check-up; decay found early can be treated without losing the bridge.

Grinding your teeth at night puts heavy load on the bridge and especially on porcelain surfaces; a night guard may be advised. Biting very hard foods or holding objects such as pens between the teeth raises the risk of fracture. How often you are seen is written into your plan, and for visitors from abroad the way follow-up is arranged is agreed at the first examination.