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Dental Bridge – Types, Treatment and Care

A dental bridge is a fixed prosthetic restoration that closes one or more gaps left by missing teeth. It is anchored to adjacent teeth or implants.

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Things worth knowing about "Dental bridge"

A dental bridge is a fixed prosthetic restoration that closes one or more gaps left by missing teeth. It is anchored to adjacent teeth or implants.

What is a Dental Bridge?

A dental bridge is a fixed prosthetic device used to replace one or more missing teeth. It bridges the gap left by the missing tooth or teeth by being anchored to the neighbouring natural teeth or to dental implants. Unlike removable dentures, a dental bridge is permanently fixed in the mouth and cannot be taken out by the patient.

Structure of a Dental Bridge

A dental bridge typically consists of the following components:

Abutment crowns: Crowns that are placed over the supporting teeth (abutment teeth) or implants on either side of the gap.
Pontic: The artificial tooth (or teeth) that fills the gap and rests on or slightly above the gum tissue.

Dental bridges can be made from various materials, including metal alloys, porcelain, zirconia, or combinations of these. All-ceramic and zirconia bridges offer superior aesthetics and are commonly used in visible areas of the mouth.

Types of Dental Bridges

Traditional Bridge

The most common type. The bridge is anchored on both sides of the gap to prepared abutment teeth. The healthy neighbouring teeth must be ground down to accommodate the crowns, which represents a permanent alteration of natural tooth structure.

Maryland Bridge (Resin-Bonded Bridge)

A more conservative alternative in which the pontic is bonded to the backs of adjacent teeth using thin metal or ceramic wings, requiring minimal or no grinding of the neighbouring teeth. This type is especially suitable for the front teeth.

Implant-Supported Bridge

Instead of relying on natural teeth, the bridge is supported by one or more dental implants. This approach preserves the adjacent teeth completely and is considered the most durable long-term solution.

Cantilever Bridge

The bridge is supported by an abutment on only one side. This design is used less frequently due to its more demanding biomechanical profile and the increased stress placed on the supporting tooth.

When is a Dental Bridge Recommended?

A dental bridge is generally indicated when:

one or more teeth are missing and the neighbouring teeth are healthy enough to serve as abutments,
insufficient bone volume is available for a dental implant,
a proven, non-surgical solution is preferred.

Treatment Process

The placement of a dental bridge typically involves several appointments:

Examination and planning: X-rays and a clinical assessment are performed to evaluate the abutment teeth and jawbone.
Tooth preparation: The abutment teeth are shaped and reduced to receive the bridge crowns.
Impression: A precise impression of the prepared teeth is taken and sent to a dental laboratory.
Temporary bridge: A temporary restoration is placed while the permanent bridge is being fabricated.
Fitting and cementation: The finished bridge is tried in, adjusted for fit and bite, and permanently cemented.

Care and Longevity

Dental bridges require special care because the area beneath the pontic is difficult to clean with a standard toothbrush. The following measures are recommended:

Use of interdental brushes or floss threaders with dental floss (e.g., Superfloss),
regular dental check-ups,
professional dental cleaning at least twice per year.

With proper care, a dental bridge can last 10 to 15 years or longer. Longevity depends on the material used, oral hygiene habits, and the degree of chewing load.

Advantages and Disadvantages

Advantages

Fixed, stable restoration without removal
Natural appearance and restored chewing function
No surgical procedure required (for traditional bridges)
Well-established, clinically proven treatment option

Disadvantages

Requires grinding of healthy neighbouring teeth (traditional bridge)
More complex cleaning routine in the bridge area
Does not prevent jawbone loss in the gap area (unlike implants)

Costs and Insurance Coverage

In many countries, dental insurance or statutory health schemes provide partial reimbursement for dental bridges based on standard treatment guidelines. Premium materials such as full-ceramic restorations may require additional out-of-pocket payment. Patients are advised to obtain a detailed treatment and cost plan from their dentist before starting treatment, as coverage and co-payments vary depending on the insurance provider and the materials chosen.

References

Shillingburg HT et al. - Fundamentals of Fixed Prosthodontics. 4th ed. Quintessence Publishing, 2012.
German Society for Dentistry and Oral Medicine (DGZMK) - Clinical Guidelines on Fixed Prosthodontic Restorations, dgzmk.de
Pjetursson BE et al. - A systematic review of the survival and complication rates of fixed dental prostheses (FDPs) after an observation period of at least 5 years. Clinical Oral Implants Research, 2012.

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