Bridges and dental implants are used to replace missing teeth. With a bridge, only the outer, crown part is restored. An implant is an artificial root made of titanium, which is integrated into the bone tissue and takes over the functions of the natural tooth root. All things being equal, a classic bridge is not able to compete with implants. Although implant placement is a physiologic technology, the bridge prosthetics supported by your own teeth does not lose ground.
What is a dental bridge
A dental bridge is a fixed prosthetic structure consisting of several artificial crowns. It allows you to restore a segment of missing consecutive tooth units from 1 to 3. Two supports are required for attachment, which are your own teeth. That is why bridges are not used when the farthest units are lost (end defect).
The classic bridge is a framework in the form of several crowns made of metal or precious alloys, covered with a layer of ceramic or plastic or metal-free – ceramic or zirconium. The two outermost crowns are hollow – they cover the supporting units. In order to tightly fix the prosthetic construction, the supports are depulped and machined beforehand, giving them a cone-shaped form. The bridge is fixed to the teeth with dental cement. It is impossible to remove the structure without damaging it.
Many specialists prefer not to tell their patients about the real disadvantages of classical prosthetics. The main one is the inability to stop the processes of bone atrophy under the bridge. When carrying out implantation, not only the crown part is restored, but also the root. The jawbone acquiring the usual load activates the processes of natural regeneration. The bone recession stops and the tissue volume is gradually restored.
What are dental implants
Implant-supported prosthetics differs from classical prosthetic technology. The method is based on the rehabilitation of the dentition without the involvement of healthy units. Instead of a missing or non-viable tooth, a separate implant – a titanium root imitating a natural tooth – is implanted, on which a prosthetic structure (crown, bridge, full denture) is fixed. Dental implants can be used to restore any number of units – from 1 to all units in a row.
Comparison of methods by characteristics
Implant and bridge prosthetics have a number of cardinal differences. Each technique is characterized by advantages and disadvantages. The doctor chooses the technology after evaluating all factors.
Advantages
Implants can withstand increased masticatory loads, evenly distributing them on the jaw, due to this they do not collapse in the process of operation. Unlike classic bridges, which require systematic re-cementation, implants are implanted once and for life.
In the case of classical bridges, the load is placed on the supporting teeth. This can lead to their gradual destruction and extraction. The size of the prosthesis will grow until there are no supporting units left. Bone atrophy will continue at the site of the defect. Implantation solves this problem.
Disadvantages
The main disadvantages of implantation include:
- high cost – but considering that the implants are installed for life, the costs are justified;
- many contraindications – nowadays the list of contraindications has decreased, new technologies have been developed;
- treatment time (if a two-stage protocol with delayed loading is used, accompanied by bone-plastic intervention) – one-stage technologies will restore the tooth row in 1-3 days.
Placement of a bridge requires the preparation of two supports. It is unfortunate if healthy units have to be traumatized. Due to uneven redistribution of mechanical load, bone atrophy accelerates, the contour of the gum changes, sags. A gap appears between the bridge and the gingiva, where bacterial plaque and food particles accumulate. Not all prosthetic structures are subject to repair and relocation. Teeth under the crowns are subject to secondary caries, which will lead to rapid tissue destruction and increase the length of the defect.
Contraindications
Implantation is a surgical intervention, with some contraindications. But unlike the classic bridge, a number of protocols can be used with serious periodontal pathologies, problems with the bite, occlusion, aggravated anamnesis.
Both methods are contraindicated in:
- inflammatory process of the oral cavity;
- Infections in the acute stage;
- chronic diseases in the decompensation stage.
The absolute contraindications to implantation include oncology, severe blood coagulation disorders. Bridges are not installed in case of end and long-term defects (loss of 4 consecutive units or more), bite pathologies, low height of dental crowns.
Possible complications
The survival rate of implantation constructions is 98-99.9%. But in rare cases, complications are possible – peri-implantitis (inflammation of tissues around the implant), rejection of the artificial root. Professionalism of the doctor, compliance with the patient’s prescriptions in the postoperative period and beyond is required for implantation of the implantation structure.
After the installation of a bridge structure, it is possible that the necks of the supporting teeth may become bare due to gum recession. Bruxism may cause the restorations to fall out of the denture. Due to incorrect redistribution of the mechanical load, the bridge wears out faster, the supports underneath it become loose and shift.
Service life
The manufacturer specifies the service life of the implant as 20 years or more. With proper care and regular maintenance by a dentist, the artificial root will last a lifetime. An implant-supported prosthetic structure requires replacement after 10-25 years at the earliest (zirconium dioxide structures – 20 years and more).
The service life of a dental bridge, due to rapid wear due to bone subsidence, is on average 6-10 years (depending on the material).
Price
When considering the question of what is cheaper, a bridge or an implant, we focus on the long-term perspective.
- Installation of a metal-ceramic bridge of three artificial crowns is 20-25 thousand rubles per unit, zirconium – 40-60 thousand rubles per unit . Preparation is paid separately – depulpation of 2 supporting units costs 10-18 thousand rubles.
- Installation of a classic ROOTT implant “turnkey” costs 28 thousand rubles, plus a metal-ceramic crown 28 thousand rubles (zirconium – 35 thousand ).
The final price of prosthetics is not too different. Taking into account that a bridge-like prosthesis will have to be re-cemented every 6-10 years, and it may be necessary to treat and restore the supporting units, implantation will allow a more economical restoration of the tooth row.
What’s best for the front teeth
A defect in the smile area can be eliminated by implantation or by placing a classic bridge. The main factor in the prosthetics of the front incisors is aesthetics. It is better to choose a bridge or a crown on an implant made of metal-free ceramic, zirconium dioxide.
What to put on the chewing teeth
In case of loss of molars and premolars, functionality is the first priority. The implant takes over the functions of the natural root, is able to withstand mechanical loads, correctly redistributing them on the jaw. In the case of a classic bridge, the load is placed solely on the supporting dental units.
In the manufacture of prosthetic systems in the clinic ROOTT use high-tech equipment, computer 3d-modeling. This gives maximum accuracy of the result of prosthetics. Crown or bridge prosthesis, created taking into account the anatomy of the oral cavity, bite and occlusion, is characterized by high comfort and will last much longer.
What is the best choice
Any prosthetic system requires support. Removable dentures can be fixed to the gums, fixed dentures require teeth or implants. If you rely on your own teeth, they are pre-treated or strengthened with pins, stump inlays. Implant support involves implanting titanium roots into the jawbone. Traditional prosthetics is a budget and short-term option, while dental implantation is a physiologically correct method of prosthetics.
| Tooth-supported bridge and dentures | Implantation | |
|---|---|---|
| Traumatic placement | Atraumatic placement | The implant is surgically implanted into the jawbone. |
| Impact on neighboring teeth | Depulping and severe grinding of the supporting teeth | Healthy teeth are not involved in the prosthetic process. |
| Restoration of chewing function | Only the supporting teeth are subjected to the chewing load. | The mechanical load is evenly distributed over the entire jaw. |
| Number of teeth to be restored | 1-4 neighboring units | Any number – from 1 to the entire row |
| Bone atrophy | Atrophic process under the denture develops faster. | Prevents atrophy, promotes restoration of bone volume |
| Secure fixation | When cement is washed out from under the crown, the structure begins to loosen. | Strong, reliable, airtight fixation of the prosthetic system with the screw method |
| Difficulty of maintenance | More difficult to remove bacterial plaque | Routine hygiene |
| Food restrictions | Hard foods must be avoided | Can eat anything |
| Comfort during wear | It takes some getting used to, gums and supporting teeth may be sore at first. | No adaptation period |
| Aesthetics | Good aesthetics | Perfect aesthetics |
| Service life | 6-10 years (depends on material and condition of supports) | Lifetime |
| Price | Affordable for all budgets | Higher than classical prosthetics |
Prolonged absence of even one tooth unit leads to serious complications – impaired chewing function, displacement of the entire row, occlusion disorders, atrophic changes in the jawbone. There are problems in the work of the temporomandibular joint, changes in facial features. It is important to quickly eliminate the defect, any of the prosthetic methods shown to the patient – with the support of teeth or implants.
The disadvantage of classical prosthetics – the need to traumatize neighboring, healthy units. No specialist will traumatize a living tooth by grinding it for a denture. We recommend this method if the patient had a bridge before, the neighboring units are also depulped or destroyed, there are contraindications to implantation.
A favorable outcome of prosthetics depends not only on the technology used, but also on the professionalism of the dentist. Specialists of ROOTT Clinic have been working in the field of prosthetics for many years, using both classical and innovative methods of treatment. Our clinic is one of the few in Moscow, where all Russian certified methods and technologies of tooth restoration are applied. The method of restoration is selected individually, according to the indications.