Dental bridge: types, treatment and costs

In the event of tooth loss, the gap between the teeth can be closed using a dental bridge. This denture can be both fixed and removable.

What is a dental bridge?

A dental bridge (short bridge) is a form of artificial denture with which one or more missing teeth are replaced. The adjacent teeth serve as pillars of the bridge, which can be used as removable and fixed dentures. The pillars are prepared like a crown and used for stabilization and fastening. There are individual dental bridges, but also those with several middle parts, which are used when several teeth are missing and need to be replaced. A bridge can close tooth gaps with up to 4 missing teeth. The different types of bridges differ according to the type of fastening and the materials.

Classification of the dental bridge according to the type of attachment in the mouth

Dental bridges are usually attached to natural teeth (“pillar teeth”). These are then each supplied with an artificial tooth crown. The crown forms the anchor and is therefore also referred to as the anchoring crown. Before the bridge can be used, the teeth to be crowned must be ground down. Since the basic principle in dentistry is to preserve as much healthy tooth substance as possible, the nature of the abutment teeth ultimately determines which type of anchoring is chosen for the bridge.

Full crown bridge

If the teeth, which are to serve as abutment teeth, are badly damaged anyway and would have to be crowned without a bridge, a full crown bridge is required.

Part crown bridge

If one of the abutment teeth is only partially damaged, the bridge can be attached to a partial crown. The partial crown dental bridge, however, has the disadvantage that the occlusal surfaces of the abutment teeth remain partially metal-colored. The bridge is also less stable than one worn on full crowns. It is possible to equip one of the abutment teeth with a full crown and the other with a partial crown.

adhesive bridge

With the adhesive bridge (also adhesive bridge, Maryland bridge), the pontic is bonded to the palate or lingual surfaces of the adjacent teeth using the acid etching technique and composite. This technique is used primarily on the front teeth and offers the option of leaving healthy teeth free of crowns.

Telescopic bridge

The telescopic bridge is a hybrid between fixed and removable dentures (combined dentures) and is useful when one of the abutment teeth is unlikely to offer sufficient stability. The dental bridge is then not attached to the abutment teeth, but connected using telescopic crowns (double crown mechanism). Internal telescopes are firmly cemented onto the supporting pillar teeth. The removable element consists of the external telescopes, which are connected to each other via intermediate elements and thus close the tooth gaps.

implant bridge

If at least three teeth are missing next to each other, an implant bridge is the best solution. First, implants are used in the jaw, which serve as an artificial tooth root and pillar for the bridge. After a healing period of approx. 6 months, the bridge is attached to them. This type of bridge is the most expensive – a three-part implant bridge to replace three missing teeth costs at least 2,400 euros.

hybr >A hybrid bridge (also mixed dental bridge, composite bridge, combination bridge) is used if at least two teeth are missing next to each other and at least one of the neighboring teeth is healthy or if the double tooth gap is at the end of the row of teeth. Both real teeth and implants are used as anchors in the jaw.

Freiendbrücke

A cantilever bridge (also extension bridge, trailer bridge) is only attached on one side and is often used when there are missing molars. If the last molars are missing, there are no more natural abutment teeth to which the rear end of the dental bridge can be attached. One end of the bridge floats freely. The abutment teeth are interlocked with one another to provide additional support.

Classification of the dental bridge according to the material used

Basically, all materials that are suitable for a tooth crown are also suitable for the manufacture of a dental bridge.

Gold: Dental bridges made of gold are very stable, but are mostly only used in the invisible part of the mouth for aesthetic reasons. The bridge base mostly consists of the gold-colored metal alloy, on which there is a tooth-colored plastic or ceramic structure.

Metal ceramic: These bridges are made of metal on the inside and are covered with tooth-colored ceramic. The metal-ceramic dental bridge is often used in the visible part of the mouth (incisors or canines).

All-ceramic: All-ceramic bridges consist entirely of tooth-colored ceramic, without any metal core. They look particularly aesthetic and can hardly be distinguished from natural teeth.

Classification of the dental bridge according to the shape of the pontics

Bridge pontics of a dental bridge can be designed in different ways.

Tangential bridge: In the case of a tangential bridge, the pontics are heart-shaped and are often used for cantilever bridges. They lie only on the sub-points or have linear contact with the oral mucosa.

Caliper bridge: The saddle bridge has an inward-arched shape so that the pontics lie on the mucous membrane over a large area. The wide support makes thorough cleaning of the bridge difficult. For this reason, saddle bridges are not used for fixed dentures, but only included as a removable element in prostheses (telescopic prostheses, partial dentures).

Suspension bridges: The pontic of the suspension bridge has no contact with the oral mucosa (approx. 3 mm distance). Cleaning is easy, while the aesthetics suffer from the gap. For this reason, floating bridges are mainly used in the lower jaw.

Split-bridge: The gap bridge also represents a form of the suspension bridge. However, it has a significantly smaller gap (approx. 1 mm) and is very difficult to clean. For this reason, it is rarely used.

Ovate Pontic: Ovate Pontic has an egg-shaped structure and "sinks" into the gums. A sufficient mucous membrane thickness is a prerequisite for using this type of bridge. The gums must also be prepared surgically and / or with the help of a temporary restoration (sufficient cavity formation).

Attachment bridges: An attachment bridge is used when the teeth that are to serve as pillars differ too much (pillar divergence that cannot be compensated for). It functions as a split bridge, in which the pontic is only anchored to the pillar on one side and connected on the other side by means of an attachment. Attachments that are used to relieve tension between the individual bridge members in multi-span bridges are called stress-breaker attachments.

When do you use a dental bridge??

A dental bridge is used for tooth gaps to improve the aesthetics as well as the speech and chewing function. Reasons for missing teeth are:

missing teeth from birth (hypodontia)
Caries
periodontosis
Dental Accident

Stable abutment teeth and careful oral hygiene are prerequisites for using a bridge.

There are a number of circumstances that can make it difficult to use:

missing bone support (attachment)
Defects in the jaw
statically unfavorable position for a dental bridge
Patient restrictions that prevent adequate dental bridge care

Dental bridge: course of treatment

1st appointment: grinding the teeth

The teeth, which are to serve as pillars, are ground and prepared in the first session. If tooth decay is present, it is removed and, if necessary, a restorative filling is placed. This ensures that the pillars of the dental bridge are parallel to each other so that the bridge can be used. Furthermore, the tooth shade for the manufacture of the tooth-colored bridge is determined, impressions are taken and a temporary denture is used to protect the teeth.

2nd appointment: intermediate sample

The interim try-in of the dental bridge is also referred to as scaffold try-in. The fit of the dental bridge is checked and it is ensured that the patient does not feel any tension. The laboratory completes the dental bridge after the second appointment. Possibly. the dentures are then veneered with ceramic. In some cases, a further intermediate try-in, the so-called raw fire try-in, is necessary. This is especially the case with large dental bridges to reduce the risk of a change in fit.

3rd appointment: integration of the bridge

In the third appointment, the bridge is inserted in the same way as the crown. The crowns are first inserted and glued. Fitting accuracy with respect to the abutment teeth and adjacent teeth as well as the absence of tension are ensured.

During the routine check-up, the integration of the dental bridge and its height are checked again.

Advantages and disadvantages of dental bridges

benefits

Long durability: A dental bridge usually lasts 10 to 20 years.
Lower expense: A dental bridge is less time-consuming to manufacture than prostheses. The methodology has become routine in every major dental practice.
Good buy function: Unlike with dentures, the chewing pressure does not rest on the gums. The jaw structure and chewing system are not burdened. This will not damage the alveolar bone under the jawbone.
Great treatment success: Dental bridges ensure a perfect smile both aesthetically and functionally.
Fixed subsidy: There is a fixed grant from the statutory health insurers for dental bridges.

disadvantage

Healthy teeth are ground: Healthy tooth structure of neighboring teeth is lost and the risk of dental disease increases. The use of a dental bridge can lead to tooth decay on the healthy abutment teeth. The crown margin is particularly at risk. The bridge can also overload the abutment teeth.
Risk of infection: Grinding the teeth increases the risk of infection. The enamel is attacked and the actually healthy tooth can be very sensitive to grinding.
Bone loss: The pontics of a bridge are not in direct contact, so that the jawbone under the replaced tooth is not stressed either. Bone slowly disappears.
Static problems: Since cantilever bridges are only attached to one’s own teeth on one side and float freely on the other side, there are static problems. The pillar teeth le >In addition to cleaning with a toothbrush and dental floss, bridge girders should also use interdental brushes or Superfloss (thickened dental floss) and thus thoroughly clean the middle section (intermediate link) of the bridge. The gap between the bridge pillar and the artificial tooth, in particular, requires special care, since food residues and thus bacteria often settle there.

With careful oral hygiene and bridge care, it can last up to 20 years or longer. However, it is important to have regular dental check-ups to ensure that timely replacement occurs in the event of premature wear.

Dental bridge: costs

Depending on the material and type of treatment, the cost of a dental bridge is between 300 euros and 2,500 euros.

What does the SHI pay for?

The statutory health insurance companies provide for a pro rata cost coverage. A regular fixed grant for dentures has existed since 2005. As a rule, this covers half of the average costs of regular care. In contrast to implants, the dental bridge is part of the standard therapy for standard care.

What is my own contribution??

For a fully veneered three-unit dental bridge, there is still an own contribution of approx. 800 – 1500 euros to be paid. With a fully managed bonus book, the subsidy from the statutory health insurance for dentures increases by up to 30%.

There are a number of services that are not part of the regular care of the health insurance companies and must be borne entirely by the patient. The fixed contribution from the health insurance does not change.

You have to bear these costs yourself:

Cost of a tooth-colored full veneer
Cost of covering the bridge in the invisible area
Costs for more aesthetically and materially demanding requests

These private services are billed via the fee schedule for dentists (GOZ) and can vary greatly depending on the price and laboratory costs.

What does the German family insurance cover??

With the DFV-ZahnSchutz you are well protected against high costs at the dentist. The supplementary dental insurance of the German family insurance was the fourth time in succession Stiftung Warentest test winner with the absolute top grade 0.5. You will receive up to 100% reimbursement for all dental and orthodontic services. Of course, high-quality bridges that go beyond the regular health insurance coverage are also included.

Medical treatment completed before the application is also included in the insurance cover. For example, the repair of an existing tooth crown or tooth filling is secured.

FAQs about dental bridges

When can bridges close a gap??

Bridges can fill gaps that span one or more teeth. The prerequisite is that the abutment teeth are stable.

How many appointments do I need for a dental bridge?

Depending on the scope and type, you need 2 to 4 appointments to use a dental bridge.

How long does the dental bridge treatment take??

As a rule, three appointments with the dentist are necessary to use a dental bridge.

What is a dental bridge attached to??

A removable bridge is attached to natural teeth or dental implants with double crowns (also telescopic crowns). A fixed bridge is screwed onto dental implants.

When must a dental bridge be removed?

A dental bridge must be removed if there is an inflammation under the bridge or the bit has changed to such an extent that the bridge no longer has a correct fit. Removing older bridges can also result from discoloration.

How long is the guarantee for a dental bridge??

Legislators generally provide a two-year guarantee for the supply of dentures. If problems arise with the bridge during this time, the treating dentist is obliged to repair them free of charge.

How much does a bridge cost for a tooth?

The costs for different types of bridges vary. A simple dental bridge on two of your own teeth, for example, costs between 850 euros to 2,100 euros.

Which dental bridge is covered by health insurance?

The health insurance company pays half the cost of a metal bridge with a front panel, according to the standard care. The patient bears an own contribution of approx. 400 – 500 euros.

What is a cantilever bridge?

A cantilever bridge (also an extension bridge or trailer bridge) is a dental bridge that has at least one bridge link that replaces the missing tooth and is only supported on one side by a pillar tooth. The other side floats freely.

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