Application of prosthetic work. Dental bridges.
Prosthetic work is work carried out in the dentist’s office, in collaboration with dental laboratories, with the ultimate goal of replacing lost dental units and improving the functionality of the aspect of the teeth still present on the arches.
Prosthetic work can be grouped in several ways:
On natural teeth – when one or more teeth on the arch are missing, dental bridges can be bonded to the remaining neighboring teeth. However, this involves grinding the remaining teeth on the dental arches and covering them with prosthetic work.
The disadvantage of this method is that natural, healthy teeth will be groomed.
The advantage of dental bridges is primarily economic as the application of dental implants would involve much higher costs.
On dental implants – implants are the ideal method of restoring edentulous spaces in the oral cavity. Thus, the underlying bone is kept active and its resorption is prevented. However, this method is not available to every patient because it involves considerably higher costs than conventional dental bridges.
A combination of dental bridges and implants – it is correct that prosthetic work is added to teeth of the same type, so either natural teeth or implants. Due to the different degree of mobility (higher for natural teeth and zero for implants), the application of dental bridges in this case will lead in time to the degradation of the natural tooth of which the mobility will increase and that will be lost after a short time.
The classic dental bridge is achieved by crowning the remaining teeth and replacing the missing teeth with a false tooth. The false tooth or teeth, that support the bridge, also called abutments are supported at both ends by crowns that are attached to the natural teeth or dental implants.
When preparing natural teeth, we can encounter two possible situations:
The tooth shows destruction or has a slightly inclined position towards the edentulous gap so that during grinding the practitioner will get very close to the nerve and then it will have to be treated endodontically.
The tooth has a favorable position and does not require excessive preparation, so its vitality can be preserved and root canal treatment is not required.
In the first situation the tooth will be devitalized before grinding, i.e., the nerve will be removed to avoid post grinding pain and complications.
Crowns can be made of chromium-cobalt metal, milled ceramic or pressed ceramic, ceramic-coated metal (CrCo), ceramic-coated zirconia.
Depending on the width of the edentulous space, the teeth supporting the bridge structure can be single, i.e., one on each side of the edentulous space, or multiple. Multiple supporting teeth are used when the edentulous space is larger and one tooth on each side would be insufficient to support the load of an extended bridge.
Making a dental bridge requires several treatment sessions.
If no pre-prosthetic preparations such as filling cavities or root canal treatments are required, the teeth can be directly polished and impressed and in the following session the caps can be probed in the case of mixed metal-ceramic or zirconia-ceramic bridges.
The average life span of dental bridges is 7 years, assuming proper hygiene, in which the use of a mouth irrigator is essential.