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Adhesive Bridge - Minimally Invasive Dental Prosthesis
An adhesive bridge is a minimally invasive dental prosthesis that replaces missing teeth without heavily grinding down the adjacent teeth. It is attached using special wings bonded to the neighbouring teeth.
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An adhesive bridge is a minimally invasive dental prosthesis that replaces missing teeth without heavily grinding down the adjacent teeth. It is attached using special wings bonded to the neighbouring teeth.
What is an Adhesive Bridge?
An adhesive bridge (also known as a resin-bonded bridge or Maryland bridge) is a type of fixed dental prosthesis used to replace one or more missing teeth. Unlike a conventional dental bridge, the adjacent teeth (called abutment teeth) require little to no preparation or grinding. Instead, the bridge is fixed to the back surfaces of the neighbouring teeth using thin metal or ceramic wings bonded with a special dental adhesive.
Structure and Materials
An adhesive bridge typically consists of three components:
- Pontic: The artificial tooth that fills the gap.
- Retention wings: Thin metal or ceramic extensions that are bonded to the inner surfaces of the adjacent teeth.
- Composite resin cement: A specialised dental adhesive that permanently bonds the wings to the tooth enamel.
Modern adhesive bridges are frequently made from zirconia or fibre-reinforced composite, as these materials offer excellent aesthetics and sufficient durability for long-term use.
Indications
Adhesive bridges are primarily used in the following situations:
- Replacement of a single missing tooth, particularly in the front of the mouth
- When dental implants are not possible or desired by the patient
- Congenitally missing teeth (hypodontia), such as absent lateral incisors
- As a temporary solution during orthodontic treatment or before implant placement
- In children and adolescents whose jaw growth has not yet been completed
Advantages
- Minimally invasive: The healthy adjacent teeth are largely preserved.
- Aesthetic: Modern materials allow for a natural-looking result.
- Reversible: Unlike conventional bridges, adhesive bridges can often be removed if needed.
- Short treatment time: Usually only a few appointments are required.
Disadvantages and Risks
- Limited load-bearing capacity: Adhesive bridges are less resistant to heavy chewing forces than conventional bridges or implants, making them most suitable for the front teeth.
- Risk of debonding: Under strong chewing forces, the bond between the wing and the enamel may loosen over time.
- Not suitable for all situations: Insufficient space or unfavourable jaw conditions may prevent the use of an adhesive bridge.
Treatment Process
Treatment with an adhesive bridge is typically completed in two to three appointments:
- 1st appointment: Impressions or digital scans of the jaw are taken and the restoration is planned.
- Laboratory phase: The adhesive bridge is custom-fabricated in a dental laboratory.
- 2nd appointment: The tooth surface is etched and the bridge is permanently bonded using a special adhesive cement.
Longevity and Care
With careful oral hygiene and regular dental check-ups, an adhesive bridge can last for many years. Studies suggest that well-planned and correctly placed adhesive bridges can achieve a survival rate of over 90% over a period of ten years. Patients are advised to avoid very hard or sticky foods to protect the bond.
References
- Kern M. - Resin-bonded bridges: The enduring mystery. In: British Dental Journal, 2016;220(8):417-419.
- Pjetursson BE, Tan WC, Tan K, et al. - A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years. In: Clinical Oral Implants Research, 2008;19(2):131-141.
- Dent. Clin. North Am. - Fixed prosthodontics: Fundamentals and current concepts. Elsevier, 2019.
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