bridgework

Bridgework refers to a dental prosthesis designed to fill a gap created by one or more missing teeth by attaching artificial teeth to adjacent natural teeth or implants. Traditional fixed bridges rely on abutment teeth on either side of the gap to support pontics, while other forms include cantilever bridges (supported on one side) and Maryland bridges (resin-bonded, with minimal preparation).

Indications for bridgework include missing teeth when neighboring teeth are healthy enough to act as anchors, when dental implants are not feasible, or when a conservative approach is preferred. Limitations include the need to modify adjacent teeth, potential changes to bite or tooth wear, and suitability concerns for patients with poor oral hygiene or high bite forces. A bridge does not address jawbone loss at the missing tooth site as an implant might.

The typical procedure begins with a clinical exam and radiographs to plan the restoration. Abutment teeth are prepared by removing a portion of enamel to allow a secure fit. Impressions are taken for laboratory fabrication, and a temporary bridge is placed during this period. After fabrication, the final bridge is cemented or bonded in place, and bite adjustments are made as needed.

Materials and design vary, including all-porcelain, porcelain-fused-to-metal, and all-metal frameworks, with zirconia increasingly used for strength and aesthetics. Aesthetics and location in the mouth influence material choice and bridge design.

Maintenance is essential: meticulous daily hygiene, including brushing, flossing with a threader or interdental brushes, and regular dental visits to monitor fit and health of the supporting teeth. Typical lifespan ranges from five to fifteen years, depending on wear, bite forces, and surrounding tooth health.

Alternatives include dental implants or removable partial dentures.