Sooner or later, adults ask themselves questions about what dental bridges are, and what is better to put on dental units to replace lost incisors, canines, and molars. Prosthetics have been used in Dentika dentistry for many years and show good efficiency at a minimal cost. Bridge structures are durable, wear-resistant, and aesthetically attractive. They are not visible to the naked eye and do not interfere during a conversation.
Despite the obvious advantages, the technique has contraindications. The doctor should advise the patient and give information about the various materials, design features, and possible adverse reactions.
When is a prosthesis needed?
The loss of dental units is not only an aesthetic problem. The absence of one or more elements in a row leads to negative consequences:
- The work of the digestive system is disrupted. This is due to the fact that foods that are not crushed enough when chewing get into the gastrointestinal tract.
- Atrophic processes in bone tissues, external deformation of the maxillofacial apparatus. Due to the lack of incisors, canines, or molars for a long time, the jaws do not receive sufficient load, there is a gradual loss of their functions.
- Change in a bite. Healthy units fill the empty space, shifting to the sides. Wide interdental spaces are formed.
To prevent the above complications, it is recommended not to postpone prosthetics and visit a doctor as soon as possible. An experienced physician is able to assess the true extent of the problem. He will select the appropriate option that will help in a particular case.
What does a dental bridge look like?
It consists of supporting crowns or implants, between which there is at least one new tooth. The dentures must be worn at all times and are not removable. Installation is necessary to replace lost structures. Along the edges are artificial micro prostheses on healthy grounds or other supports. In intermediate areas, whole incisors, canines, or molars are installed.
Retainers are required to hold the system. They support the entire apparatus. According to the method of fastening, bridge structures are divided into the following types:
- Classic. Undamaged units are completely covered by the coronal part.
- Adhesive. Materials are fixed on partially damaged tissues, most often with the help of an adhesive composition.
The second option is more welcome because this way you can save the “native” rows. However, the final decision must be made by the dentist.
Materials
The choice of the type of denture and bridge (photo below) depends on the clinical picture and the wishes of the patient. Before installation, criteria such as wearing comfort, visual appeal, and service life are taken into account. All these parameters primarily depend on what basis the apparatus is made of. Most often, clinics offer metal-ceramic and ceramic products, since they have a lot of advantages.
Plastic is also used for the manufacture of micro-prostheses. They are suitable only for temporary wear, because they are short-lived, uncomfortable, and quickly become unusable. During this time, the appearance also changes, the plastic base turns yellow, becomes dark, or completely collapses. Such unreliable elements must be placed during the manufacture of permanent bridges.
Cermet
A metal-ceramic dental bridge – what is it in dentistry (photo below), and what are its advantages? The product is based on a metal frame, which is covered with ceramics on top. Service life – more than 7-8 years, all this time the external attractiveness is preserved.
Other benefits:
- Wear resistance, strength, durability, and resistance to mechanical stress;
- Aesthetics;
- Complete restoration of chewing function in the patient;
- Low cost;
- Minimal risk of developing allergies.
This is the most popular type of bridge structure. When choosing a material, it is important to pay attention to the existing limitations.
When you can not insert a metal-ceramic prosthesis
Contraindications:
- The absence of four or more units;
- Pathological changes in bite;
- Bruxism (grinding mainly during sleep);
- Gum disease;
- Abrasion of cutters;
- Inflammation in the oral cavity;
- Parafunction of chewing muscles;
- Insufficient height of the supporting elements;
- Poor hygiene and subsequent infection;
- Problems with blood clotting;
- Allergic reactions to components;
- Mental disorders.
Dental bridges that are currently available are different from those that existed in the past. A couple of decades ago, the installation of the product was unacceptable for many diseases. Now this list is not so extensive. Materials are becoming more advanced, modern technologies make the procedure accessible to everyone.
Metal
Such models are cast and stamped. Assignment to one type or another depends on the method of connection. Elements are made of gold, as well as chromium alloys with cobalt or nickel.
With one-piece casting, dentition can experience significant stress. The shape of the crowns is reproduced with amazing accuracy.
Stamping means that the parts are soldered to each other. They are unreliable and cause the galvanic syndrome. At the moment, they are practically not produced, since the products are not aesthetically pleasing enough, and the price of the precious metals used can be high.
Cons of using metal alloys
Negative sides:
- There is a taste of iron in the mouth;
- Unattractive compared to cermets;
- The likelihood of oxidative processes that affect the state of the gastrointestinal tract (typical for old-style models).
Plastic
Doctors note that a dental bridge is a product that has been worn for years and does not lose its attractiveness and functionality. Plastic elements are created from a special polymer containing acrylic. Aesthetically attractive prostheses are obtained, which are characterized by hypoallergenic and the absence of discomfort for the wearer.
However, such micro prostheses have significant disadvantages. They are fragile and wear out quickly. It is for this reason that their scope is rather narrow, they are only suitable for temporary use, while a model is being made from cermet or metal alloy. In addition, plastic is indicated in cases where it is necessary to eliminate the aesthetic defects of the anterior incisors that do not experience constant stress, and the patient is limited in finances but wants to look presentable.
How to put a bridge on your teeth
Manufacturing and installation take place in several successive stages:
- The oral cavity is being rehabilitated. The dentist must treat caries and eliminate other problems, it is important to get rid of all pathological processes. Particular attention should be paid to the units that will subsequently serve as support. They are de-pulped (nerves are removed and channels are cleaned), then they are sealed. Then grinding is performed to securely fix the coronal elements. This manipulation is called dissection.
- The doctor selects a shade. The main criterion is the color of the enamel of all rows in the mouth, and the personal preferences of the patient are also taken into account.
- Impressions are taken from both jaws. In this case, it does not matter whether the upper or lower is restored.
- In the laboratory, a corrective product is made according to individual parameters. On average, this process takes 2-3 weeks. All this time it is recommended to wear plastic models.
- When ready, fitting and fitting are performed. If necessary, everything is returned for revision.
Fixation is carried out only when a person does not experience discomfort when putting on and taking off. The dentist must make sure that the bite and closure of the rows are correct. In addition, compatibility with the natural enamel layer is evaluated by shade.
You can also get How to Handle a Loose Filling When the Gums Have Fallen Away from the Tooth
The installation is attached to a special medical cement. Upon completion of the procedure, the patient receives recommendations for proper care.
Bridge construction or implant: what to choose
Some people are not happy with how the bridge looks on their teeth (photo below). Others fear that during the sharpening, most of the healthy tissues will be damaged, and the supporting elements will simply fall off. There are other negative points that doctors pay attention to:
- Pressure is unevenly distributed on the chewing surface in the oral cavity;
- Enamel suffers because its integrity is violated;
- The product has a short service life.
Even if the cermet was installed, in no more than 10 years it will become unusable. This is one of the factors that can influence the choice in favor of implantation, which guarantees the preservation of an attractive smile for decades. However, it is up to the attending physician to decide what is preferable to mount.
The patient expresses his wishes regarding the appearance and the final cost. Before making a decision, it is important to compare all the advantages and disadvantages, and then dwell on one or another design, depending on financial capabilities.
Successful combination
It also happens that the best solution is to use a complex model that combines the simultaneous installation of one of the types of dental bridges on the teeth to restore lost units and implant the implant. This happens in situations with complete edentulism, that is, when the mouth is completely empty, and there is nothing to attach the bridge to.
In this case, artificial elements are mounted as a support, and a prosthesis is fixed between them. This is the best option for patients who would never agree to wear dentures.
How is it filmed
Cases when dismantling is required:
- The support was not well prepared. The doctor performed the filling poorly, as a result, there was a risk of an inflammatory process.
- The cement composition has collapsed. The restoration procedure is impossible without removing the structure.
- The operational period has ended. Old elements are dismantled, and new ones are fixed in their place.
- The crown was released with a marriage. It can fit loosely and as a result injure the mucous membranes in the oral cavity, affecting the bite.
- There was loosening and loss of individual parts.
Procedure for the dentist:
- Sawing. The crown is removed using a special tool that pries off the edges. If this is not possible, you need to cut the material. It will not work to save the integrity of the installation.
- Removal by Koch apparatus. Under the influence of ultrasonic waves, the cement is destroyed, then the device itself is applied directly. The artificial element is loosened by shocks, and the natural incisors, canines, and molars, together with the cavities, remain intact.
Does it hurt to remove a dental bridge?
The procedure usually does not cause pain. Pain occurs when there is a living unit under the crown, in which the inflammatory process has begun. But this rarely happens, because usually bridge structures are mounted after depopulation, that is, pain should be completely absent. If necessary, the doctor applies anesthesia.
If the product is removed, and discomfort persists, this may indicate injury to the mucous membranes or the development of pulpitis, or periodontitis. In such a situation, endodontic therapy is indicated.
Possible problems and complications
Even when conducting high-quality diagnostics and receiving recommendations from the dentist about which dental bridges are best placed on the teeth in a particular situation, it is not always possible to avoid unpleasant consequences. Prosthetics can be complicated by the following problems:
- Inflammation of the soft tissues at the points of contact of the gums with artificial material;
- Periodontal atrophy;
- Loosening, loss of incisors, canines, and molars;
- Pulpitis;
- Abrasion of enamel on opposite rows;
- Bite changes;
- Allergic reaction.
The occurrence of the above complications depends on the production processes and compliance with all technologies, preliminary examination of the patient for allergies, and other negative reactions to cermets, and metal alloys. Any suspicious sign should be the reason for contacting the clinic.
What to do if the dental bridge staggers
This can happen for the following reasons:
- One of the supports fell out completely or broke;
- Popped up two supporting elements;
- The cement composition on which the installation rests collapsed.
To establish provoking factors, the dentist must ask the patient how long the bridge has been in the oral cavity, and whether the service life has come to an end. It is also important to understand what sensations a person has gone through in prosthetics experiences.
Not only a visual examination is carried out, but also an X-ray examination. Only after a thorough diagnosis will it be possible to determine where the problem came from and how to deal with it in a particular situation.
Temporary restorative measures are excluded in this case. The product is dismantled. This is especially true when the support breaks and falls out.
Conditionally removable prosthetics
As mentioned above, many dentists install only non-removable bridges on the teeth, which means that it is technically impossible to get the structure if desired. However, there is another option for mounting the installation. This is the same prosthesis, only with a single intermediate part. Fasteners-locks are mounted instead of crowns.
The solution is suitable for both artificial and natural units preserved in the oral cavity. This does not affect the enamel, and the elements can be painlessly removed.
Summing up
Having dealt with the types of permanent and temporary bridges, as well as what a removable dental bridge is (a photo of dental elements with locking mechanisms is presented in the previous subsection), the patient will be able to make the right decision depending on individual preferences and financial capabilities. The issue should be resolved jointly with the doctor in order to avoid complications and other negative consequences.