I want to take care of my 4 abutment teeth. I would like to know what kind of dental bridges is more recommended so that the abutment teeth will stay healthy considering the pressure of the bite and the heaviness of the bridge. Would you recommend a lighter or a heavier bridge? Would you recommend a pure porcelain or porcelain fused to metal? I have 4 molar abutment teeth and i really want to preserve them because i dont want to wear removable dentures someday. Please help. Thank you
Which Type of Dental Bridges Would You Recommend to Make the Abutment Teeth Last Longer and Healthier?
Doctor Answers (9)
The best way to preserve your abutment teeth would be to do an implant supported bridge. If this is not possible, I believe a porcelain fused to metal bridge would probably be the longest lasting. A ceramic (metal free) bridge will look a little better, but isn't likely to last as well in a long span bridge.
Preserve your Teeth
The best way to preserve your "abutment" teeth isnot to cut them dwon for a bridge to begin with. The "Standard of Care" has shifted away from bridges and moved to implant supported crowns. Implants done and restored by a skilled dental team have a longer life expectancy than a bridge and take any extra stress on abutment teeth completely out of the equation. This also makes for a smarter long term investment.
If you for any good reason can not get an implants to replace your missing teeth, then the most conservative preparation is in order to make a crown is a full metal (gold) crown, next by amount of tooth structure that needs to be removed is porcelain fused to metal and third would be all ceramic restoration. That is theoretical answer, however every individual need personal approach. You should discuss your options with your restorative specialist ( prosthodontist) and he, after analyzing your teeth, periodontium and bite ,will advise what is the best for you. Remember the best preservation of your teeth would be not touching them but if you will decide to restore your edentulous spaces, you will have to sacrifice some of the tooth structure. Good luck!
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What Kind of Bridge Works?
Since I am not sure where you need to have a bridge, this is a difficult question to answer. We have many options to replace missing teeth but each has pros and cons and is determined by where the bridge is located and what is needed.
Conventional Bridges have been successful for years. These are usually Porcelain Bridges which can be successful for years as long as you can clean it , take care of it, have regular cleanings and take radiographs to check as needed.
There are non-metal bridges if the area to replace is in an esthetic zone. There are Maryland type bridges that are fantastic but are used mainly in the front.
Implants are a great option but can be costly. The reason so many dentists like them is because they don't touch the teeth next to the missing teeth. If you already have crowns on those teeth, sometimes it is better to take off the crowns, clean them up and then connect them to 'bridge over' the missing teeth.
As always, talk to your dentist-If you need another consultation-get it!! Its all about trust and relationships.
Materials and longevity
When looking at different materials for a bridge, be it gold alloy, porcelain fused to metal or all porcelain, the choice is mainly aesthetic with a small consideration to occlusal forces. The longevity of a dental bridge relies mostly on the fit. Bridge retainers which are accurately made to fit and seal along the tooth margin will prevent bacteria from leaking under the bridge abutment. When bacteria builds up along a poorly sealed margin, decay along the margin will ultimately result in failure of the abutment and bridge.
Since a bridge is a single restoration fabricated to look like a series of component teeth, failure of a bridge can be a functional and financial tragedy. I would recommend you discuss the practicality of implants for single tooth replacements and/or an implant retained bridge. Implant/crown margins are not susceptible to decay like their tooth/crown counterparts.
Material choice for bridges not a factor in longevity of abutment teeth
Material selection relates to the longevity of the bridge itself and less to do with the abutment tooth structure. Healthy abutment teeth relate more to hygiene habits and bite management.
If an implant is simply not possible, then a bridge made of eMax or Lava would be a great choice.
Bridge or implant
Most single missing teeth are best replaced with an implant in 2011. With implants, the abutment teeth are not prepared at all. This would be the best possible result.
Some situations are not ideal for implants and regular dental bridges are still a great option. The bridge abutments that have the longest life and the healthiest lifespan are the result of proper occlusion and optimum hygiene care. The cleaning around fixed bridges requires more effort and skill by patients. When you team with a great hygienist (professional cleaning and instruction), your bridge and abutment teeth sould last decades - and potentially a lifetime.
What Type of Dental Bridge will Last the Longest?
Dental bridges can last a long time, sometimes even decades.
You are thoughtful to be concerned about the long-term health of the abutment (or anchor) teeth. I wouldn't think about it as a "light or heavy" dental bridge, though. A lot of the long-term durability has to do with the pressure and balance of your bite.
Make sure your cosmetic dentist spends time analyzing your bite before you start the work. You may need your bite fine-tuned or corrected before the bridges are started. This is called equillibration, meaning to equalize the bite.
Some patients need gold on the chewing surfaces, this makes them chip-proof. It can enhance how long the dental bridge lasts. Some of the newer all-ZIrconia (such as the brand name Lava from 3M) can be used for full ceramic bridges, though we don't have as much research about the long-term durability of these bridges.
Another option to help these abutment teeth to last longer is to not put bridges on them. By that I mean to consider using dental implants in the bridge space. By replacing the missing roots you won't have to put as much force on the abutment teeth.
Bridges, abutments, implants
All missing teeth should be replaced by implants and single crowns. Not brdges. I recommend Lava, all porcellain bridges to replace single missing teeth, but only if you are not a candidate for implants and single metal free crowns.