Dental Education Lecture: Bridge vs. Implant

Fig.1

Fig.2

Fig.3

Fig. 4

Fig.5

In last lecture, we talk about crowns and bridges. Crowns are used to repair our broken down teeth or improve appearance, whereas bridges are used to replace one to two missing teeth.  The disadvantage of bridges is that we have to shave down adjacent teeth for support and connection.  If the adjacent teeth are healthy (so-called virgin teeth), the sacrifice is not so worthy.  It is difficult to clean bridges.  After shaving, the bridge-anchoring teeth are much more likely to get cavities and/or gum diseases. Therefore, we should avoid bridges if possible.

A 30-year-old lady wants to fill the space in the front (Fig.1).  One of her front teeth has never come out, due to the presence (blockage) of a miniature abnormal tooth as shown in Fig.1.  Because of this mishap, she never attended a dancing party in high school. For her age, the ideal treatment is to extract this abnormally shaped tooth and the front tooth underneath the gums and then place an implant.  However, the impacted unerupted tooth is usually fused to the jaw bone.  The extraction may be extremely difficult.  This young woman is scared of surgery. If she were 20 years younger, we could have extracted the small tooth and dragged the impacted front tooth gradually into the normal position through braces to avoid major surgery.  At young age, the unerupted tooth has not bound to the bone so tight.  Anyway, we decide to cut down the neighboring teeth to make a bridge (Fig.2).  She leaves office very happy.  We wonder whether she goes to a party immediately.

The young lady in Fig.3 has 4 bridges in the back of her mouth. She is aware of drawbacks of bridges.  She accepts implant for her front tooth the moment she learns about implant option. Although she is also afraid of surgery, she goes through treatment smoothly and satisfactorily (Fig.4).  Fig.5 (X-ray) shows that the neighboring teeth remain intact.

Crowns, bridges and implant are all called fixed restorations, because they stay in your mouth.  You do not feel almost any difference from your natural teeth if the restorations are properly made.  In the beginning of next chapter, we will discuss dentures, which are removable restorations.  You take them in and out.  Dentures are relatively big, clumsy, replacing several to all of missing teeth   However, implants are unique.  We can use them to replace one to all of missing teeth.  We still feel normal. If you want to know more about dentures and implants, go to next chapter: Senior.

Xin Wei, DDS, PhD, MS 1st edition 02/12/2009, last revision 02/14/2009