Dental bridge as a dental prosthesis
definition
The Dental bridge belongs to the stuck dentures and serves that Gap closure. The simplest bridge consists of 2 parts: the Bridge anchor (also called bridge piers) and the Ponticthat replaces the lost tooth. This type of dental bridge is often used in the anterior region because it is too unstable for the posterior region, where the chewing forces are strongest.
Figure dental bridge
Dental bridge
(here as a fixed denture)
- Dental bridge with one
Bridge pontic
(single span bridge)
with several pontics
(multi-span bridge) - Tooth gap
(leads to tooth migration,
Jaw problems etc.) - Tooth abutments
(Abutment tooth) - Ground healthy teeth
(Bridge anchor) - Bridge pontic
(Part of a dental bridge)
Bridging process:
A - missing tooth
B - tooth (abutment tooth) on the left
and the right is sanded off
C - The dental bridge will
firmly attached
D - Healthy teeth with
Dental bridge (dentures)
You can find an overview of all Dr-Gumpert images at: medical illustrations
When do you need a bridge?
If you lose Teeth is the Chewing function considerably disturbed. There are various additional disorders of the tooth gap. Also the Language education can be impaired, especially if one front tooth is missing.
First of all, the antagonists, i.e. the teeth on the opposite side of the gap, no longer find any contact and, since they find no resistance, grow out of their tooth socket. This later leads to difficulties with a prosthetic restoration. All teeth are in contact with one another. If that is lost, the neighboring teeth have a tendency to get into the Tilt gapbecause they no longer have any contact. This also creates difficulties when a prosthesis is subsequently fitted. If teeth in the visible area are affected, it plays aesthetics of course also a decisive role.
What does a dental bridge cost?
bridges and Crown are prosthetic services that statutory health insurance funds (GKV) after submitting a treatment and cost plan Take part of the cost.
It is important to present a receipt for the amount of the grant ("Bonus Booklet"), which proves regular visits to the dentist.
Private bills privately insured (PKV) are paid by the cash registers depending on the tariff concluded. The amount of the invoice is determined individually.
The prices for a bridge depend on the respective design. On the one hand, that means which material is used, on the other hand how large is the span of the bridge.
The cheapest option is a Base metal bridge in the posterior region. If this bridge is tooth-colored and veneered with ceramic, or if it is made entirely of ceramic (e.g. zircon), the bridge becomes more expensive.
The span of a bridge describes how many members the bridge consists of, including abutment teeth and bridge members. If, for example, a bridge closes a gap between two adjacent teeth, this variant is tripartite: 2 crowned teeth and, in connection with this, a bridge pontic that supplies the gap. The more pontics or abutment teeth are included, all the more expensive is the bridge.
In general, a 3-unit bridge between two teeth can cost between 800 - 1200 euros be expected. It also depends on how high the individual bonus is with the health insurance company maximum 30% paid for it.
If the patient has a very low income, it can be worthwhile to get one from the health insurance company Hardship application through which the respective health insurance company would cover all costs if the application is approved.
Pain under a dental bridge
Pain under the bridge can be uncomfortable and have a variety of causes, which is why they must be investigated by a dentist. Probably the most harmless cause is washed out and missing cement under the bridge, which means that the abutment teeth are no longer tightly enclosed. As a result, the teeth can already hurt when you breathe cold air. As soon as the bridge is inserted with new cement, however, the pain is no longer noticeable.
Furthermore, the nerves of the abutment teeth can become ignite and pain, which results in a root canal treatment. After optimal root canal treatment, however, there should be no more pain.
Another reason for pain can be Caries under the abutment teeth, after which the bridge should be removed to take care of the tooth decay. After the carious lesions have been removed, cleaned and filled, the bridge can be reattached.
Another cause can also be a Inflammation of the gums apply under the pontic due to food residues that have not been removed, which no longer causes any discomfort after thorough cleaning and regression of the gums.
One of the teeth may also be fractured (i.e. cracked or cracked), which can cause severe pain under the bridge. These teeth are provided they are in the longitudinal axis Broken are no longer worth preserving and would have to be drawn.
The various causes of pain make it impossible for those affected to assess how bad the individual complaints really are and should be done as quickly as possible dentist examined and explored so that the pain can be relieved quickly and the dental bridge can be preserved.
Dental bridge hurts when chewing
Kicking pain on a bridge during the Chewing process on, this can have multiple causes.
In the majority of cases, this pain occurs shortly after insertion on and can through a Pre-contact arise. The bridge touches the opposing teeth of the other jaw in front of all other teeth and is therefore subjected to significantly more pressure than in the normal situation. The problem can be solved by using the dentist the dragging away too high places.
Furthermore, the nerve can come from one of the Buttocks inflamed and caused inflammation below the tip of the root. The tissue below the tip of the root swells and makes the tooth slightly higher, so that a pre-contact is also formed. When clenching, the tooth is repeatedly pressed into the inflamed tooth socket, which leads to Pain leads.
What to do if the dental bridge is loose
If the bridge wobbles in the oral cavity, if it can be moved with the tongue or if it has come loose completely, there is an urgent need for treatment. A dentist should be consulted immediately.
If the bridge comes loose, for example on the weekend or on a public holiday, the emergency service does not have to be contacted immediately. It is advisable to put some toothpaste in the bridge and place it on the bridge abutments. The toothpaste becomes harder over time and can temporarily fix the bridge for one to two days. At the next opportunity, however, the dentist should be consulted for attachment.
In most cases only the cement is washed out and the bridge can be reattached without any problems. Although phosphate cement is used for permanent insertion, something can come off the cement after several years, so that the bridge loosens.
However, if an abutment tooth has broken off or caries under the bridge, the teeth must be treated in advance and then it must be checked whether the shape of the bridge can still be used. If necessary, a new bridge must be created.
Find out more about inserting dentures with cement at: Phosphate cement
How do you clean a dental bridge?
The dental bridge, like the other teeth, comes with a Toothbrush and toothpaste cleaned with fluorides. The only place that cannot be reached with the toothbrush is the area below the bridge that rests on the mucous membrane.
Depending on how the pontic is designed, it is cleaned differently:
Is it a so-called "Ovate Pontic", then the area between the pontic and the oral mucosa is not cleaned as a "Growing" of the mucous membrane to the bridge is desired is. Because of the firm bond, no food residues get into the space and the dentures look more realistic and aesthetic.
You can recognize an Ovate Pontic by the fact that there is no visible space to the gums. In case of doubt, please always use the Ask the dentist.
If the pontic is not designed in the form of an Ovate Pontic:
For this area under the bridge there is special floss (Superfloss), which is softly coated and whose end is reinforced. This end can be attached to the pontics under the pontic threaded and then the coated part can clean the part of the bridge that rests on the mucous membrane with back and forth movements. In this way, food residues that are often caught in this area can be easily removed.
Initially, cleaning with the special dental floss is a matter of practice, but this is the only way to remove deposits and residues below the bridge. If these residues are left under the bridge, the gums can become inflamed and the abutment teeth become more prone to caries, as the bacteria move along the gums towards the teeth. The bone compartment in which the teeth are located can also become inflamed and retract, so that the teeth become loose and, in the worst case, threaten to fall out.
Bridge swallowed - what to do?
Will be a bridge accidentally swallowed, don't panic should be spread. It is advisable to go to the dentist so that he can remove the bare tooth stumps with one Provisional can supply what they are protected with. The materials of the bridge are not digestible and the bridge comes out exactly as you swallowed it. At the next bowel movement this should be caught so that the bridge can be found again. After this then cleaned and disinfected can this again used become.
However, if the bridge span is so large that the bridge is in Trapped in your esophagus, stomach, or intestines it may have to be surgically removed. That should be customized with the Dentist and family doctor be discussed. He or she may consider having an x-ray of the chest and abdomen.
Types of dental bridges
If teeth are still present in front of and behind the gap, the replacement of the lost teeth is an option teeth through a dental bridge. The remaining teeth are used as bridge abutments to anchor the dental bridge. One speaks of a single-span dental bridge when the loss of only one tooth needs to be replaced.
Are there several teeth next to each other or are there two gaps but one of their own tooth is still present in between, it is a multi-span bridge. The part of the dental bridge that covers the gap is called the pontic. If there is no longer a separate tooth, an implant can also be used as a fixation (i.e. abutment tooth).
To produce the dental bridge, the bridge abutments must be ground so that they can be provided with a crown, mainly made of gold. In the process, of course, healthy hard substance is lost.
After taking impressions of the upper and lower jaw, the dental bridge is completed on the plaster model in the dental laboratory.
Read on under: Dental impression
The chewing surfaces are modeled in such a way that they are precisely adapted to the opposing bite. The dentist then attaches the completed dental bridge to the bridge abutments with cement.
A variation of the bridge restoration is possible if the dentition allows, inlays are used as anchoring instead of ground abutment teeth. The advantage lies in reducing the loss of hard tooth substance.
The bridge piers and the replaced teeth can be clad with ceramic or plastic.
Materials for a dental bridge
Nowadays, the materials of a bridge body are no longer limited to veneered ones Metal frameworkas it was a few years ago. Metal frameworks gold hardly exist anymore because the price of gold is so high. Base metal is the new material for metal bridges, which consists of an alloy of chromium, cobalt and molybdenum. The non-precious metal bridge has good functional properties and has proven itself as a material so far. As long as the gray-silver color in the posterior area does not bother the patient, this variant offers an excellent opportunity to create long-lasting dentures. The metal framework can be tooth-colored with Ceramic veneered are and is aesthetically very demanding.
Aesthetically even better results can be achieved Zircon bridges achieve. Zirconium dioxide is a high-performance ceramic, which can be confusingly similar in color to your own teeth. For laypeople it is hardly possible to determine whether it is their own teeth or a prosthetic restoration. In terms of chewing stability and function, the ceramic is in no way inferior to the metal restoration. Only the price of the ceramic supply can be a little higher.
Ceramic dental bridges
Ceramic is the highest quality material used for bridges and crowns most aesthetic option to produce tooth-colored dentures. By modeling many thin ceramic layers on top of each other, the transparency and coloring of the bridge can be adapted to your own teeth so that a layperson cannot distinguish the bridge from your own teeth. In addition, there are no differently colored bridge margins as with a veneer bridge.
In this way, optimally fitting results can be achieved, especially in the anterior region. Furthermore, the tolerance is to be rated very positively, because it hardly any allergies or intolerances against the components of the ceramic there.
It is also common these days to mill ceramic work from a block. Previously, the dentures were created as a 3D model on the PC, which is then executed by the milling machine. This makes it possible to avoid long waiting times for the patient, as the bridge can even be used on the same day, provided the practice has such a system (CAD / CAM).
Durability of a dental bridge
The dentist grants after making dentures 2 year guarantee, in which all repairs that are not your own fault are under goodwill. The average durability of bridges is between 7-10 yearsHowever, it can of course also last much longer, whereby the individual position, dental situation and prognosis are also decisive. If teeth are already weakened by periodontal disease, for example, the prognosis is much worse and shorter-lived than with healthy teeth.
Periodontal disease on a dental bridge - is durability at risk?
If the entire tooth support system or only the teeth under the bridge are affected by inflammation, this is called periodontal disease. In addition to the mucous membranes, this inflammation primarily affects the bones, which then recede. The teeth then stand no more so stable in the bone and the bridge can be with your teeth wiggle. Are the Abutment teeth less than 20% in bone, do you have to drawn because they are not worth preserving. If the process is not yet so advanced, periodontal treatment at the dentist can help.
Advantages and disadvantages of a dental bridge
The decision whether a bridge or a Implant With a crown, the individually optimal solution for a gap treatment is not always easy to find.
In general it can be said that Implant the best solution is then and only if the Neighboring teeth completely healthy and do not have any fillings. In this case, a bridge would remove healthy tooth structure, which is not advisable.
Do the neighboring teeth, however large plastic or amalgam fillings, can the bridge also the Protect neighboring teeth and strengthen and would be advisable in this case. Furthermore, the cleanability of an implant crown is much better than that of a bridge. Of the Stop both dentures are comparable positive.
For the patient it is advantage a fixed denture (e.g. a bridge) in the restoration of normal bite conditions with little disruptive foreign material in the oral cavity. In addition, the oral mucosa is not stressed. There are no visible holding elements, no impairment of the taste. The shelf life is included 10 years and more.
Of the disadvantage is the loss of healthy hard tooth substance when grinding the abutment teeth. Oral hygiene is also more difficult compared to removable ones dentures. If for any reason one of the abutment teeth is lost, the entire dental bridge must also be removed.
Summary
A dental bridge replaces missing ones teeth. It is attached to ground abutment teeth. The material used is largely gold. Ceramic or plastic veneering of the abutment teeth and the replaced teeth is possible and essential in the anterior region.
