What kind of dental bridges is best to preserve the health of the abutment teeth?I have 4 molar abutment teeth & 6 continous PONTIC upper front teeth including canine. It is a long span bridge and I like to know what kind of bridge would you recommend to make my abutment teeth last the longest considering the pressure while eating and the heaviness of the bridge?Would you recommend a heavier or a lighter?Porcelain of fused to metal? I have to preserve my abutment teeth. Please help. Thank you.
Which Type of Dental Bridges is Best for 4 Abutment Molars & 6 PONTIC Upper Front Teeth to Make the Abutment Teeth Last Longer?
Doctor Answers (10)
Long bridges will always fail
The span you describe is too much, and is not limited by the material chosen. No matter what material you try, the bite forces will destroy the abutment teeth. Dental implants should be the first/best choice, and a partial denture the alternative.
Long span dental bridge vs. Implants
You ask a great question an there are some great answers. In fact a bridge that you described is a contraindicated procedure in dentistry as there are more that 3 adjacent pontics and canines are missing. Dental implant supported bridges are an option, as is a removable partial denture anchored to implants. You should consult with you dentist again.
Dental Implants versus fixed bridges
I will second all the responses below. Whereas it will be a bit more of an investment on your behalf, it will most likely cost less in the long run. Dental implants are now predictable and can be an excellent way to replace your missing teeth and allow you the best option to keep your abutment teeth. Be sure to use dentists and specialist who have experience with this type of dentistry.
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Bridges, abutments, implants
You need implants in the anterior area, followed by porcelain fused to gold bridgework.
I would really reccomend to have implants placed on the missing teeth and a bridge on the implants.
Lets say 2 implants to replace the canine,2 implants to replace the central incisors and a bridge placed on top of those.
Long Span Bridge is not a good idea
The fixed bridge you describe with 10 teeth involved was common in years past and served some people with strong bone well. Others lost their supporting teeth (abutments) from the forces applied. Todays technology allows for implants to support the bridge that should last many years. Best of luck to you.
Ten Unit Bridge
A bridge as long as you described is NEVER A GOOD IDEA. Having six front teeth supported by only four in the back is very unstable. I would rather see you have crowns placed on the back teeth and investigate having two to four implants placed in the anterior to support an implant retained bridge.
Your first step should be a consult with an implant specialist. In our office we use a 3-D Cone Beam CT scan to determine if there is sufficient quantity and quality of bone to accept implant placement. We design the bridge using a CAD/CAM system and then virtually place the bridge in the scan so that optimal implant location can be determined. The scan is also used to define and provide a surgical guide for accurate implant placement so that all implants are placed in the correct location, angle and depth.
The result will be posterior crowns which are not being over stressed by the unstable bridge. Instead the anterior bridge will be completely supported by a fixed implant base.
Some great descriptions and videos of these procedures and technologies are available on our website.
Long Span Bridge
A long span bridge is never the best option when compared to implants. If you haven't discussed an implant supported restoration with your dentist, you should do so or get a second opinion. A long bridge flexes and is more prone to breakage or becoming unglued than a short span bridge. Sometimes implants can be used to create two smaller bridges. This is the longest lasting, most secure option. Without knowing your situation, I can't tell you anything for sure, but I would get a good recommendation for an implant dentist in your area and get a couple of opinions. If implants are not a possibility, then the rule of thumb is "one root for each pontic". So if you are replacing six single rooted front teeth, you would have the abutments on the premolrs and first molars on each side. So you would have three abutment teeth holding the bridge on each side of your mouth. When you have less than this, you get more flex and a shorter life span out of the bridge.
How to maximize abutment tooth health
This is a very complicated case with many variable to be considered but here would be my reccomendations
1. porcelain fused to metal seems to have the best strength over a large span and has some flexibility to withstand the forces
2. Zirconium would be a more esthetic option but the shearing of porcelain to the framework seems to be recurrent problem
3.The option of adding implants as secondary stabilizing abutments is an option to consider but the occlusion needs to be carefully adjusted and there are risks of adding implants and natural teeth together.
4. make sure that the majority of the occlusal forces are focused over the abutment teeth and that other forces are minimized
Best Dental Bridges
I would recommend implants to be placed on pontic areas & single crowns on abutments if you're a candidate. Consult with an implant specialist to determine if implants can be placed, specialist would need to do a CT scan x-ray to determine if there is any bone loss & also check the sinus cavity sometimes the specialist has to do a procedure called sinus lift to allow implants to be placed properly. Doing implants will also take the stress off the abutment teeth for lasting results. Usually on front teeth all porcelain material is used no metal.