Judging by the photo before you make any decision on what type of bridge work to do, I would certainly
recommend moving the teeth around so that the gaps are the right size. I would
move the front teeth closer together to open up the areas where the teeth are
missing. Once that is achieved then we can make an assessment for an ideal
bridge form. A ceramic bridge is more aesthetic even though the literature
tends to say some of the porcelain bonded metal is. Technology and newer ceramics have increased in strength and aesthetics.
So once you have moved the teeth into the right
position and opened up those spaces accordingly, my recommendation is ceramic
bridge or ideally an implant in that area but to do that sort of movement would
require some sort of orthodontics. Invisiline would work well for
this sort of treatment.
Just looking at your photo, I can clearly say that I would simply place ceramic bridges along with ceramic (porcelain) crowns to close all of your gaps and drastically enhance your smile. I would NOT recommend porcelain fused to metal crowns or bridges because they are not as cosmetically appealing as ALL ceramic. If you've ever seen a person with a dark ridge around the top of their tooth, or even a tooth that just looks a little more dull in shade, then that person likely has a porcelain-fused-to-metal crown. I would suggest consulting an excellent cosmetic dentist that can fix your teeth in 1 or 2 appointments. I have transformed many smiles like your's into smiles like Nene Leakes in 1 or 2 appointments. Good luck and I hope this helps. Follow me if you have more questions.
Sarah Thompson, DMD
For front teeth I would recommend all ceramic to give the most natural looking appearance. With either option it may be difficult to close the space completely between the two front teeth. The bridge teeth would look too big and unnatural. If you are OK with leaving a little space in between those teeth then two all ceramic bridges could look very nice.
Just off hand I don't see any way to get an acceptable esthetic result with just doing a bridge as you suggest. You would be better served by going through orthodontics first.
If you're considering two bridges to close the spaces where you are missing your lateral incisors, based on the photos it appears that it would look very unnatural and disproportional to attempt to close the very large space between your two front teeth. However, if you would be pleased with only closing that space partially, then it seems that would certainly be a possibility. Your dentist can do something called a "diagnostic waxup" on models of your teeth to show you what it would/could look like before committing to having the two bridges.
Other treatment methods would include doing orthodontics (braces) first, and then bridges or implants.
Your treatment is a challenging one, and I certainly recommend you get several opinions from different dentists and preferably an orthodontist, before choosing on a particular treatment.