Bridges: Pontic, Maryland, or Bonded?
Bridges are relatively easy-to-make transformative prosthetic for missing teeth. They are noninvasive and require no healing time. They can be used in conjunction with implants as a temporary yet fixed replacement (alternatively, a flipper or denture can be used) until patients heal from the implant surgery. But for short term use, please see our section on provisional bridges.
There are three different types of bridges that can be made.
1. Regular Pontic Bridge - Also known as fixed partial dentures, retainer crowns, and just bridges, these prosthetic can replace up to three or four missing teeth at a time. A simple way of describing them would be two crowns connected together by (a) solid replacement tooth/teeth in between the two. Mastication forces will act along the entire bridge so the natural teeth must be strong enough to withstand these forces.
2. Maryland Bridge - Instead of creating two crowns for the supporting teeth, which requires the teeth to be prepped (losing its natural enamel), the Maryland Bridge is bonded to the back of teeth by its wings without having to prep the teeth. Maryland bridges come in various forms to match each patient's particular need, but the basic shape is that of an artificial tooth/teeth with at least two "wings" or tabs on either side. The tabs may be metal or resin based on professional review.
3. Bonded Bridge - Some bridges require more support than the natural teeth can offer (usually because the bridge is longer than average). One way to create more support is by adding a metal wire to the back of the bridge (facing the inside of the mouth where it cannot be seen). Another way is to bond, or cement using resin adhesive, the bridge to several teeth on either side of the bridge.
The Procedure: Based on what type of bridge is being made, the first step is typically prepping the adjacent teeth. Any decay must be removed and the crown shaped for attachment. A mold will then be taken and sent to the lab to be processed. Once fabricated, the bridge will be permanently cemented onto the prepped teeth. For maryland bridges, no prep is required and the wings of the bridge will be bonded to back of the two teeth on each side. Bonded bridges require a wire (nonmetal) to be bonded to several spots on the bridge and then onto natural teeth on each side.
Before You Come In: The health and condition of the teeth at each end of the bridge is essential for any bridge. Please make an appointment for an evaluation. Dr. Lee will also discuss with you what kind of material is best for the bridge (please see our section on crowns for a full list of materials). At this time, you must also address any esthetic concerns or technical questions you may have.
What You Can Expect Afterwards: Bridges, like crowns, do not have the same strength as natural teeth. Avoid cracking shells and eating hard foods like corn and nuts with your teeth. Regular gentle flossing and cleaning under and around the bridge is highly recommended with a prophylactic brush.
Model of a dental bridge. Missing tooth was replaced by a fake tooth matching the tooth on either side.
Note: Adjacent teeth must be healthy enough to support fake tooth.