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Archive for the ‘Dental Bridges’ Category
Dental Bridge Prices Questions and Answers.
Some of the questions we have been asked recently by our blog visitors about dental bridges.
What is dental bridge?
A bridge is a dental appliance used to restore missing teeth for a patient. It can replace as few as one missing tooth, or the teeth of an entire upper or lower jaw. It is usually permanently cemented to existing teeth that are prepared by a dentist to have caps or crowns placed over them. It can also be placed on implants. Not all patients are candidates for bridges. An evaluation by a dentist would be required. The cost of bridges is very expensive compared to removable partials or dentures, which can be a fraction of the cost.
Denture or partial: $500 to $2000
Bridge: $600 to $1200 (per each missing or capped tooth)
Each tooth replaced: three-unit bridge replacing 1 missing tooth:
3 x $1000 to $3000;
Replace a full upper or lower jaw: 14 x $1000 = $14,000
Information about 2 kinds of bridges: fixed bridges, cantilever bridges and resin-bonded bridges.
Fixed bridges are permanently cemented and can not be removed by a patient. A cantilever bridge can be supported by a tooth or can be suspended from the bridge structure.
What is dental bridge procedure?
This is the process of preparing the teeth for a cap or crown for a bridge to be completed, including the necessary mold or impression for a dental lab to make the bridge.
Can dental bridge be sent to the dental office or do I have to visit dental office myself?
No, a bridge needs to be custom-made by a dentist for each patient.
Cost of dental bridges and factors affecting the price.
Bridges are usually priced by the unit or number of teeth involved. Examples: $600 to $1200 per unit each missing or capped tooth or each tooth replaced, i.e., three-unit bridge replacing one missing tooth:
3 x $1000 = $3000?
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More about dentures:
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch.
Patients can become entirely edentulous (without teeth) due to many reasons, the most prevalent being removal because of dental disease typically relating to oral flora control, i.e. periodontal disease and tooth decay. Other reasons include tooth developmental defects caused by severe malnutrition, genetic defects such as Dentinogenesis imperfecta, trauma, or drug use.
Advantages
Dentures can help patients in a number of ways:
1. Mastication – chewing ability is improved by replacing edentulous areas with denture teeth.
2. Aesthetics – the presence of teeth provide a natural facial appearance, and wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that occurs after losing teeth.
3. Phonetics – by replacing missing teeth, especially the anteriors, patients are better able to speak by improving pronunciation of those words containing sibilants or fricatives.
4. Self-Esteem – Patients feel better about themselves.
Types of dentures
Removable partial dentures
Removable partial dentures are for patients who are missing some of their teeth on a particular arch. Fixed partial dentures, also known as “crown and bridge”, are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth. Fixed bridges are more expensive than removable appliances but are more stable.
Complete dentures
Conversely, complete dentures or full dentures are worn by patients who are missing all of the teeth in a single arch (i.e. the maxillary (upper) or mandibular (lower) arch).
Prosthodontic principles of dentures
Support
Support is the principle that describes how well the underlying mucosa (oral tissues, including gums and the vestibules) keeps the denture from moving vertically towards the arch in question, and thus being excessively depressed and moving deeper into the arch. For the mandibular arch, this function is provided by the gingiva (gums) and the buccal shelf (region extending laterally (beside) from the posterior (back) ridges), whereas in the maxillary arch, the palate joins in to help support the denture. The larger the denture flanges (part of the denture that extends into the vestibule), the better the support. This last sentence requires comment and correction, it reveals some misunderstanding by the author as flanges usually provide stability and not support. Indeed, long flanges beyond the functional depth of the sulcus are a common error in denture construction, often (but not always) leading to movement in function.
Stability.
Stability is the principle that describes how well the denture base is prevented from moving in the horizontal plane, and thus from sliding side to side or front and back. The more the denture base (pink material) runs in smooth and continuous contact with the edentulous ridge (the hill upon which the teeth used to reside, but now consists of only residual alveolar bone with overlying mucosa), the better the stability. Of course, the higher and broader the ridge, the better the stability will be, but this is usually just a result of patient anatomy, barring surgical intervention (bone grafts, etc.).
Retention.
Retention is the principle that describes how well the denture is prevented from moving vertically in the opposite direction of insertion. The better the topographical mimicry of the intaglio (interior) surface of the denture base to the surface of the underlying mucosa, the better the retention will be (in removable partial dentures, the clasps are a major provider of retention), as surface tension, suction and just plain old friction will aid in keeping the denture base from breaking intimate contact with the mucosal surface. It is important to note that the most critical element in the retentive design of a full maxillary denture is a complete and total border seal (complete peripheral seal) in order to achieve ‘suction’. The border seal is composed of the edges of the anterior and lateral aspects AND the posterior palatal seal. The posterior palatal seal design is accomplished by covering the entire hard palate and extending not beyond the soft palate and ending 1–2 mm from the vibrating line.
As mentioned above, implant technology can vastly improve the patient’s denture-wearing experience by increasing stability and saving his or her bone from wearing away. Implant can also help with the retention factor. Instead of merely placing the implants to serve as blocking mechanism against the denture pushing on the alveolar bone, small retentive appliances can be attached to the implants that can then snap into a modified denture base to allow for tremendously increased retention. Options available include a metal hader bar or precision balls attachments, among other things.
Complications and recommendations.
The fabrication of a set of complete dentures is a challenge for any dentist, including those who are experienced. There are many axioms in the production of dentures that must be understood; ignorance of one axiom can lead to failure of the denture case. In the vast majority of cases, complete dentures should be comfortable soon after insertion, although almost always at least two adjustment visits will be necessary to remove sore spots. One of the most critical aspects of dentures is that the impression of the denture must be perfectly made and used with perfect technique to make a model of the patient’s edentulous (toothless) gums. The dentist must use a process called border molding to ensure that the denture flanges are properly extended. An array of problems may occur if the final impression of the denture is not made properly. It takes considerable patience and experience for a dentist to know how to make a denture, and for this reason it may be in the patient’s best interest to seek a specialist, either a prosthodontist or perhaps even a denturist, to make the denture. A general dentist may do a good job, but only if he or she is meticulous and usually he or she must be experienced.
The maxillary denture (the top denture) is usually relatively straightforward to manufacture so that it is stable without slippage.
A lower full denture should or must be supported by 2-4 implants placed in the lower jaw for support. A lower denture supported by 2-4 implants is a far superior product than a lower denture without implants, because
1) It is much more difficult to get adequate suction on the lower jaw.
2) The functioning of the tongue tends to break that suction, and
3) Without teeth the ridge tends to resorb and provides the denture less and less stability over time. It is routine to be able to bite into an apple or corn-on-the-cob with a lower denture anchored by implants. Without implants, it is quite difficult or even impossible to do so.
Some patients who believe they have “bad teeth” may think it is in their best interests to have all their teeth extracted and full dentures placed. However, statistics show that the majority of patients who actually receive this treatment wind up regretting they did so. This is because full dentures have only 10% of the chewing power of natural teeth, and it is difficult to get them fitted satisfactorily, particularly in the mandibular arch. Even if a patient retains one tooth, that will contribute to the denture’s stability. However, retention of just one or two teeth in the upper jaw does not contribute much to the overall stability of a denture, since a full upper denture tends to be very stable, in contrast to a full lower denture. It is thus advised that patients keep their natural teeth as long as possible, especially their lower teeth.
Source: www.wikipedia.com
References
- The inventions that changed the world, Reader’s Digest (1982) [Portuguese edition of 1983]
- Moriyama N, Hasegawa M. The history of the characteristic Japanese wooden denture. , Bull Hist Dent. 1987 Apr;35(1):9-16.
- John Woodforde, The Strange Story of False Teeth, London: Routledge & Kegan Paul, 1968
- S. E. Eden, W. J. S. Kerr and J. Brown, “A clinical trial of light cure acrylic resin for orthodontic use,” Journal of Orthodontics, Vol. 29, No. 1, 51-55, March 2002
Text is available under the Creative Commons Attribution-ShareAlike License; additional terms may apply.
Denture Reline
After a new denture has been inserted, it ought to retain in the mouth quite nicely due to the fact that the shape of the inside of the denture base conforms closely to the shape of the gums. (Please note that good retention or suction of the denture does not necessarily mean that the same denture is stable.) Unfortunately, the longer you wear the denture, the more your gums change underneath it and the looser it gets. In order to restore the retentive qualities of the denture, and to prevent the production of flabby gum tissue under it, you should have the denture professionally relined at least every two years.
There are actually three types of denture relines: hard, soft and temporary.
Hard denture reline
This is the kind of reline that should be done on all full dentures every two years. The dentist removes some of the plastic from the inside of the denture and fills the denture with a soft material (think of soft putty) which, when replaced in the mouth, conforms to the contours of the tissues, then hardens to a rubbery consistency. When the denture is removed, the denture now contains an accurate impression of the shape of the gums. The denture is sent to the lab, and the impression material is replaced with pink, hard acrylic in exactly the same shape as the original impression material. When returned, the denture now conforms to the contours of your mouth and should make maximum contact with the tissues producing maximum suction. In our office, the impression is scheduled for first thing in the morning. The patient goes home without the denture, but returns later the same day (usually early afternoon) for the insert (fitting appointment).
Soft denture reline
Occasionally, a patient finds that he cannot wear the denture because his gums are too tender, and he keeps getting sore spots. In cases where the patient is unable to wear ordinary dentures because of tender gums, the denture can be relined with a material that remains somewhat pliable for a year or two before it needs replacement. The consistency of this material can range from waxy to hard rubber, and is generally less likely to give the patient sore spots than ordinary pink acrylic.
Unfortunately, by the time that a patient resorts to a soft reline material to make the denture wearable, it usually means that factors other than simple sore spots are partly to blame for the difficulties that the patient is experiencing wearing the dentures. These could include an overbuilt denture or a resorbed ridge which is so unstable that the patient must keep constant force on the teeth to keep them in place. Both of these conditions can be corrected, sometimes with less expensive simple surgery or sometimes with much more expensive implant retained dentures.
Temporary denture relines (Therapeutic relines)
Frequently, by the time a patient with an old denture finally shows up at the dentist’s office looking for a new denture, the dentures have not been serviced for such a long time that the gums are in terrible condition. They may be red, swollen and quite misshapen. Relining the old denture, or building a new one using impressions taken while the gums are in such poor condition would lead to a denture that would simply perpetuate the problem with the new appliance.
When faced with situations like this, a dentist will frequently resort to a temporary, or palliative (medicated) reline material to allow the inflammation to subside. This reline makes the denture fit much more tightly, and is usually soft and pliable. It will not last more than a few months, but the patient wears it for a few weeks until the gums return to a more normal state. After this happens, then the patient is ready for his new denture or hard reline.
Dental bridges for replacing missing teeth
What are the parts of a typical dental bridge (fixed)?
A dental bridge essentially consists of:
- A pontic or false tooth used to replace the missing tooth, which is made from gold, alloys, porcelain, or a combination of these materials.
- Two crowns serving to anchor the false tooth in place.
When are dental bridges needed?
Bridges are recommended when there are one or more teeth missing that affect:
- Your smile and appearance.
- Your bite, as a result of adjacent teeth leaning into the space and altering the way the upper and lower teeth bite together.
- Your speech.
- The shape of your face.
- The rates of gum disease and tooth decay as a result of food accumulated in the gap.
Must missing teeth be replaced?
Yes, missing teeth must be replaced for many reasons:
- To improve your appearance.
- To reduce the strain on the teeth at either side of the missing tooth.
- To prevent the neighboring teeth from leaning into the resulting gap and altering the bite.
- To prevent gum disease and tooth decay due to accumulation of food in the gap.
There are three main types of dental bridges:
1. Traditional fixed bridge
This is the most commonly used type of bridge and consists of a pontic fused between two porcelain crowns that are anchored on neighboring teeth or implants. The pontic is usually made of either porcelain fused to metal or ceramics. These are fixed and cannot be removed.
2. Resin-bonded bridges or Maryland-bonded bridges
These are chosen when the gap to be filled is in between the front teeth, or when the teeth on either side of the missing tooth are strong and healthy without large fillings. The false tooth is made of plastic and is fused to metal bands that are bonded to the adjacent teeth using resin that is hidden from view.
3. Cantilever bridges
These are opted for in areas such as the front teeth that are susceptible to lower stress. Cantilever bridges are used when there are teeth present on only one side of the space, where the false tooth is anchored to one or more adjacent teeth on one side.
What are bridges made of?
Bridges may be made of
- Porcelain.
- Porcelain bonded to precious metal.
- All-metal dental bridges (gold).
How are dental bridges fitted?
At the first appointment:
- The dentist will numb the area with a mild anaesthetic.
- The teeth on either side of the space are prepared by trimming away a small area in order to accommodate the new crown over them.
- The dentist then uses dental putty to make an impression of the teeth, which will be used to make the bridge and crown in the laboratory.
- A temporary bridge is fitted in to protect the exposed gums and teeth.
- A Vita shade guide may be used to determine the right shade for the dental bridge, by selecting a shade that resembles natural colour variations in your teeth, as well as suits your complexion, hair color, the color of your natural teeth and even your eye color.
At the second appointment:
- The temporary bridge is removed and the custom-made bridge is fitted, checked for its fit and bite, and adjusted accordingly. It is then cemented into place.
- Multiple visits are often required to check and adjust the fit.
- In case of permanent or fixed bridges, the bridge is temporarily cemented for a couple of weeks and checked for its fit. It is permanently cemented only after several weeks.
How long will dental bridges last?
Dental bridges can last 10-15 years, provided that you maintain good dental hygiene and eating habits.
How to take care of your dental bridges?
Practice good dental hygiene:
- Clean the dental bridge every day to prevent tooth decay, bad breath and gum disease.
- Clean under the false tooth every day.
- Keep the remaining teeth healthy, as these serve as the foundation for the dental bridge.
Brushing and flossing:
- Brush twice and floss daily.
- To floss, use a bridge floss threader, which is a flexible piece of plastic with a loop at one end to thread the floss.
- Thread one end of a 14-to-18-inch piece of dental floss through the loop, making sure to leave one side about half as long as the other.
- Insert the end of the flosser without the hole between the bridge and the gumline.
- Hold onto the longer piece of floss, gently bring it up and pull the pointed end all the way through.
- Floss using both hands, moving the floss back and forth under the bridge.
- Floss the bridge completely from one end to the other.
Diet and eating habits:
- Eat soft foods or food cut into small pieces until you get accustomed to the dental bridge.
- Eat a balanced and nutritious diet for good general and dental health.
What are the advantages of dental bridges?
- They are natural in appearance.
- They generally require only two appointments with the dentist.
- They have a good life period, lasting for 10-15 years, providing you maintain good dental hygiene.
- They improve your appearance, bite issues and speech problems occurring as a result of missing teeth.
What are the disadvantages of dental bridges?
- Teeth become mildly sensitive to extreme temperatures for a few weeks.
- They require healthy tooth tissue from neighboring teeth to be prepared.
- Your teeth and gums are vulnerable to infection as a result of accumulation of bacteria due to the food acids (if proper hygiene is not maintained).
Dental Bridges.
Bridge Treatment
A bridge is a device a dentist inserts to fill a gap where a tooth is missing. A “conventional” bridge consists of a false tooth (or teeth), known as a pontic, which is affixed to a crown on a tooth next to the gap. A “Maryland” bridge, on the other hand, is where the pontic is fixed to the teeth on either side using wings, meaning that it is not necessary to fit a crown to the other teeth.
Why do I need a Bridge?
Your dentist will recommend a bridge for cosmetic and clinical reasons. A missing tooth following an accident can obviously be unsightly and traumatic, and a bridge is an effective way to solve this problem. However, a dentist will also use a bridge in situations where it has been necessary to extract a tooth because of advanced decay. The clinical advantages of using a bridge are that it will reduce strain on the surrounding teeth, and prevent problems with the patient’s developing bite; surrounding teeth will often start to move into a gap, and food can become trapped, leading to increased decay and gum disease.
Alternatives to Bridges
There are two main alternatives to a dental bridge: dentures or dental implants. Dentures are not always the best solution if only one or two teeth need to be replaced because they can cause difficulties with eating and even speaking, so be sure to seek your dentist’s advice. Dental implants consist of a titanium “screw” which is inserted through the jaw, to which an artificial tooth is attached. Again, these are not always suitable- a patient must be medically fit, have healthy gums and a sufficiently thick jawbone to allow for this procedure. Implants are becoming more widely used, despite these reservations, and despite their high cost.
Consulting a dentist about a Bridge
Your dentist will usually recommend a bridge in situations where one or two teeth need to be replaced. Your teeth and gums must be healthy enough to support the bridge, so the dentist will evaluate this on the initial consultation. X-rays and other tests will be performed to ensure that the dentist can build a bridge that will be functional and cosmetically acceptable for a number of years.
What is involved in fitting a Bridge?
If using a standard bridge, the dentist will remove a small portion of the teeth around the gap to accommodate the thickness of the new crown (or pontic, as above). An impression of the patient’s bite will then be taken, and a device called a facebow may be used to ensure that the patient’s jaw movement is accurately recorded. This information is then used to design the bridge, ensuring that it is the best possible fit.
The bridge itself is a semi-flexible structure, which is then bonded to the teeth, and the dentist will ensure that the replacement tooth is correctly aligned. This will occur at a second appointment, allowing time for the bridge to be built. The dentist may fit a temporary bridge during the period between appointments.
Bridges toward the rear of the mouth will usually be made of a precious metal substructure with a porcelain tip that has been coloured to match the rest of the teeth. For gaps towards the front of the mouth, dentists will often use a bridge made entirely of porcelain. This is more visually attractive, but also more expensive.
After the Bridge is fitted
There should be no significant side effects after a bridge is fitted. They are easier to get used to than a denture, and with careful cleaning should last for many years.
Specials
Click on the image.
Click on the image for golden denture teeth.
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