The following series of blogs will cover the different areas of dentistry. The aim is to simplify and explain the jargon that patients encounter in the normal course of dental visit. It is based on the Ontario Dental Association’s procedure categories and descriptions.
In the previous blog we discussed removable prosthetics – namely variations on dentures. Fixed prosthetics or bridge work covers a range of artificial teeth that are attached to the teeth or other supporting structures and remain in the mouth. That is to say they are not removed on a daily basis for resting tissues and hygiene.
Like real bridges that have abutments, so to do dental bridges. Generally there is one abutment on either side of the missing tooth or teeth. To ensure stability, the more teeth being replaced the more abutments are needed to support the artificial teeth.
Abutments may be full crowns (see the previous blog) or if conditions permit partial crowns and inlays. They may be straightforward or very complex constructions depending on individual needs and circumstances.
To again use the world at large analogy, the artificial tooth (teeth) that are between the abutments are referred to as pontics or the bridge. Pontics like crowns are made from various materials and are specific to the individual needs of your mouth.
Bridges like crowns and fillings may need repairs and maintenance. Where possible the repair will take place in the mouth. However, sometimes the problems of an abutment are such that the whole bridge must be removed to remedy the problem. Removing a cemented bridge is no easy feat. If the goal is to remove it in one piece, then there may be complications. Usually the safest means of removal is to cut it off. This renders the bridge useless afterwards – so a new bridge is needed.
Removable partial dentures, though trapping significant amounts of plaque, are easier to clean. Fixed bridges are harder to keep clean, so recurrent decay is a very real concern. Hence the occasional need for repairs.
Once a bridge has been removed in one piece and repaired, it must be reinserted. This may take as much time or longer depending on the repairs, than when it was initially placed.
Fixed bridges are cemented back into place with a dental cement.
Fixed bridges that are supported by implants may be cemented in place or screwed into place. This will be determined by the original construction. If screwed in, the bridge can be relatively easily removed and replaced. If cemented, the same concerns, risks and difficulties apply as with conventionally cemented bridges.
Teeth ravaged by gum disease may be maintainable when they are splinted together. There are several ways to splint teeth to improve their stability, but the best aesthetics and function is generally using crowns that are “splinted” or tied together. They are not by definition replacing missing teeth, but acting as one long pier.
The process of fabrication is identical to that of crowns and bridges.