Tooth Loss – Causes and Problems
Loss of teeth is a very important issue, which has a negative impact on a person’s mastication, phonetics and aesthetic appearance.
Tooth loss is usually caused by:
1. Dental Caries
2. Advanced periodontitis
3. Injury (jaws or teeth)
4. Internal or external tooth absorption
Loss of teeth usually results in other problems, such as:
1. They adversely affect one’s appearance.
2. The person’s smile is affected.
3. Speech is affected (there may be some falsehood if a front tooth is lost)
4. Lack of teeth.
5. Causes their neighbor teeth to slip into the empty space, as well as the antagonist tooth of the opposite jaw. The reason is the lack of resistance, as a result of which it begins to loosen and descend below the level of the chewing level.
6. In addition, there is the issue of bone resorption at the site where the tooth is missing. Thus, if the patient in the future decides to have an implant, it will not be possible because there is will be not the appropriate bone thickness needed to place the implant.
What is dental Bridges
A bridge is a fixed prosthetic restoration (that is to say permanent in the oral cavity) that replaces one or more missing teeth of the patient’s normal dentition.
The dental bridge rests on some existing teeth that serve as braces to adhere to the artificial teeth that replace the missing ones.
An Implant dental Bridge can also be placed if the patient has an extensive tooth loss.
It can also rely on a natural tooth and an implant. This is called mixed support.
Tooth Bridges – Types
Tooth bridges are categorized in 2 types:
1. Depending on their technique of supporting the oral cavity:
The classical type: the classical type bridge, is the most common method of constructing a bridge. It consists of a number of intermediate artificial teeth, which are joined by two abutments which are located at both ends of the structure and are mounted on two prepared teeth, which fix the bridge in place.
This type of bridge is mostly used as a temporary type of prosthesis or for a construction when 1-2 teeth are missing, mainly anterior. It will stay in the mouth for a couple of years and then be replaced with an implant even with a classic type bridge, which remains in the mouth until permanent prosthetic work is done.
The artificial teeth consist of a skeleton having one or two wings extending to the back of the adjacent teeth.
Dental Bridges with Cantilever:
It is a solution used when we are missing teeth and cannot have braces on both sides of the bridge. In these cases, the dental bridge is supported by an abutment only on one side, so 1 of the artificial teeth on one side of the construction is not supported by a tooth (cantilever).
When the number of missing teeth is large, there is not enough support to have a classic bridge type. By inserting one or more implants, we replace missing teeth, and so implants play the role of abutment teeth.
2. Depending on their construction material:
Metal-Ceramic Dental Bridges:
One of the most common methods of a dental bridge construction.
They consist of a metal frame which is completely covered with ceramic material (porcelain). They are very durable and are used in a variety of cases where a bridge can be fitted.
It is considered the most used bridge in dentistry today.
All-Ceramic Dental Bridges with Zirconia frame (porcelain dental bridges):
It is a state-of-the-art prosthetic restoration, where it is fully manufactured and covered with a special type of ceramic material with zirconia frame, without the addition of metal.
Because porcelain can imitate diamonds with incredible naturalness. The aesthetic effects of the all-ceramic bridge are unique.
This is why they are used in the anterior region because of their better aesthetics.
CAD – CAM Zirconium Monolithic Dental Bridges:
Dental bridges made of CAD-CAM monolithic zirconium are the most advanced dental material technology in fixed prosthetics. They have unique strength and the material they make up allows the light to penetrate giving them the aesthetic characteristics of a natural tooth.
In terms of strength, they outperform simple alloy ceramics and therefore their main application is on the posterior areas due to the chewing and the large forces exerted.
Metal Dental Bridges:
They consist of a metal frame (usually gold, gold platinum, cobalt-nickel alloys, and a combination of these and other metals). Nowadays they are not used because of their aesthetic characteristics (the color does not match the color of other teeth), even though they have high durability.
They are made entirely of plastic polymer.
In terms of durability and aesthetics, they do not cover the needs of a permanent construction, therefore they are only used for temporary restorations until the permanent one is installed.
Dental Bridges – The treatment
The dental bridges are immovable prosthetic restorations which have a very demanding construction process. To get the perfect result more than 2 sessions in the dental office are needed.
Initial visit: all problems (eg caries, fractures) that have occurred on the natural teeth on which the bridge will rest as well as the patient’s overall oral hygiene (gingivitis, periodontitis, etc.) must be addressed.
As long as the patient’s oral hygiene returns to normal (which is very important, because if we do not have good oral hygiene, we will create more problems), then we can proceed with the preparation of the teeth so that give them the proper shape for fitting the bridge over them.
Then we take the impressions and send them to the dental technician to start the process of making the bridge.
Then, on the same day, the dental technician makes a temporary prosthetic so that the patient can go out without having an aesthetic problem.
On the second visit: the Dental Bridge is tested if it fits properly into the prepared-grinded teeth and gums.
Then the correct color that will be given to the bridge must be selected to match the color of the other teeth.
Last visit: see if the bridge fits into the teeth and gums, as well as check the aesthetics of the other and the functional part.
When we confirm that everything is as it should be, then it is permanently adhered to the prepared teeth.
The patient must know that if he or she wishes to whiten the teeth, he or she must first finish the whitening treatment and then proceed to the bridge construction. And this is because the color of the teeth needs to take its final shade before proceeding to the dyeing process to find the color of the final prosthetic work.
It is our job to create a structure that will fit in harmoniously with the orthognathic system.
Tooth Bridges – Postoperative Stage
After bonding the bridge over the grinding teeth, the patient should not chew on the bridge for at least 3 hours, to allow the adhesive to coagulate well and have the maximum bonding and durability.
If the tooth vital, then the patient may feel slight discomfort for 2-3 days, which is perfectly normal.
Tooth Bridges – Final result
The recovery of aesthetic self-confidence of the patient.
The recovery of the patient’s smile.
Restoring the patient’s aesthetics, chewing function and phonetics return to pre-bridge levels, often even to better levels than before.
The average life span of a bridge is about 10 years.
Extending its life span depends largely on the patient’s oral hygiene, as well as on how often he visits his dentist, to re-examine his oral health and prosthetic restorations.