A dental bridge is a fixed dental prosthesis that replaces one or more missing teeth by attaching artificial teeth (pontics) to dental crowns (anchor crowns) cemented to adjacent teeth (abutments). Dental bridges restore chewing ability and aesthetics lost by tooth loss. They are preferable to removable dentures as bridges do not require removal for cleaning and provide more natural chewing comfort. However, bridges require tooth preparation that removes healthy tooth structure from abutments. With proper maintenance, bridges can provide an effective long-term solution for missing teeth.

1. Fixed bridges

2. Definition
A dental bridge is a fixed dental prosthesis used to replace one
or several missing teeth by permanently joining an artificial
tooth to adjacent teeth or dental implants.

3. Overview
• Dental bridges are also used to protect and reshape teeth that have
undergone major destructions and prevent complications that may arise as
a result of tooth loss.
• There is a wide variety of dental bridges. The type of bridge that is
designed for a particular clinical situation depends on many factors such as
geographical location, patient desires and financial situation, practitioner
preferences etc.
• Although in the past years, dental implants tend to replace them,
traditional dental bridges (supported by natural teeth) are still widespread
throughout the world.

4. What is the structure of a dental bridge?
A dental bridge consists of two components :
• Anchor crowns
• Pontics or artificial teeth

5. What is the structure of a dental bridge? -
Anchor crowns
• The anchor crowns (also known as retainer crowns) are two (or more)
dental crowns that are cemented to the teeth adjacent to the toothless gap
to support the bridgework restoration.
• The two anchoring teeth are called abutment teeth. A traditional bridge is
supported by natural teeth. Bridges supported by dental implants are
discussed in a separate chapter.
• Anchor crowns hold the bridge in place and provide support for the
pontics. If we imagine that a dental bridge is a bridge over a big river, the
anchor crowns along with the abutment teeth are the pillars.

6. What is the structure of a dental bridge? -
Pontics or artificial teeth
• The pontic is the part of the bridge that replaces the missing tooth (or
teeth). For that reason, it is also called dummy or artificial tooth.
• The artificial teeth are placed between the anchor crowns and basically
replace the missing tooth or teeth. Most of the times, the pontic is placed
between the abutment teeth (with the exception of the cantilever bridge)
and is permanently joined to the anchor crowns.
• Depending on the clinical situation and the number of missing teeth, a
dental bridge can have one or more pontics.

7. dental bridge with a single pontic dental bridge with two pontics

8. Structure and chewing forces
• During mastication, all chewing forces that act on the pontics are
passed to the abutment teeth; the more artificial teeth, the greater
the forces acting on the abutment teeth.

9. Structure and chewing forces
• Each individual pontic passes the chewing forces to the abutment teeth.
That is why the forces that act on the abutments are greater when the
bridge has more pontics (image above).
• It is not advisable to overextend the pontic. As a general rule, it is
considered that a single toothless gap with more than 4 missing teeth
cannot be restored with a traditional dental bridge. There are 2 reasons
behind this:
• If the pontic is too extended, there is a risk of breaking during the chewing
process
• The forces that act on the abutments are extreme and there is a high risk
these teeth become loose causing the restoration to fail

10. how a dental bridge is designed? :

11. What are the main benefits of a dental bridge? -
restoration
1. Restoring the missing teeth
The primary role of a dental bridge is to restore (or replace) the missing
teeth. Besides "bridging" the toothless gap, the bridge will also "crown" the
abutment teeth.
As with any type of dental rehabilitation, one of the most important goals is
restoring the main oral functions as close as possible to natural teeth Let's
see how a dental bridge can accomplish this objective.
• Chewing process
A dental bridge is permanently fixed to the abutment teeth. All chewing
forces pass along the abutment teeth to the jawbone.
The amount of pressure that acts on each abutment depends on the extent
of the bridge (the number of missing teeth) and abutment teeth
characteristics.

12. What are the main benefits of a dental bridge?-
restoration
Look at the picture above: all chewing forces that act on the pontic are passed to the abutment
teeth.
Unlike bridges, some removable dentures rest exclusively on the gums. Consequently, chewing
comfort decreases (because the patient will chew on his gums instead of his teeth) and getting used
to removable dentures takes a little longer.
Very important: Dental bridges do not pass any chewing forces to the gums. Basically, the whole
chewing process is performed by the natural teeth. That is why chewing on dental bridges has a
natural comfort.

13. What are the main benefits of a dental
bridge?- restoration
• Aesthetics
• Tooth loss severely affects aesthetics, especially if the area is visible.
Therefore, restoring the aesthetic function is, for many patients, the
most important goal.
• Restoring proper aesthetics greatly depends on the manufacturing
material. Porcelain or zirconia bridges are aesthetically superior.
restoring aesthetics with a porcelain dental bridge; before and after

14. What are the main benefits of a dental
bridge?- restoration
• Phonetics and pronunciation
• If front teeth are missing (especially the upper incisors), normal
speech is impeded, particularly the pronunciation of consonants.
When a new dental restoration is manufactured, it takes time to
adapt the speech to the new conditions.
• Unlike removable dentures, dental bridges are smaller restorations
that are permanently cemented to the abutment teeth. The oral
structures (tongue, lips etc) will need less time to get accustomed to
the new situation.

15. What are the main benefits of a dental
bridge?- Preventing the complications
2. Preventing the complications that may arise after teeth loss
• If a toothless gap is left unrestored, irreversible changes may take
place around this area with an adverse effect on oral health. Let's see
some of the changes that may occur following a tooth extraction.
• Teeth migration can lead to the disruption of the most important oral
processes: mastication, aesthetics, and phonation. Moreover,
migrated teeth can suffer from periodontal diseases or cavities.
• When the toothless gap is restored with a dental prosthesis (such as a
dental bridge or an implant-supported restoration), teeth migration
stops.

16. What are the main benefits of a dental
bridge?- Preventing the complications
Opposite teeth, marked with a, migrate towards the extraction site (over-eruption). The
process occurs until the tooth reaches the opposite gum (the edentulous ridge) or another
obstacle located on the path.
Adjacent teeth, marked with v, lean toward the edentulous space, in an attempt "to close
the gap".

17. advantages of dental bridges
1. Bridges are fixed prosthetic restorations that do not require
periodic removal for cleaning
• Because of this advantage, many patients prefer them against
removable dentures. Bridges are permanently fixed by cementing the
anchor crowns to the abutment teeth and there is no need for
periodic removal.
• Many patients are more comfortable with the idea of a fixed
restoration rather than a removable one.

18. advantages of dental bridges
2. Patients get used to dental bridges in a short time
• Bridges are small and lightweight dental restorations. After the definitive
cementation, getting used to dental bridges takes less time than in case of
removable dentures (or other more complex restorations) which are larger and
heavier.
3. Dental bridges provide excellent chewing comfort
• Chewing comfort is excellent because all chewing forces are passed to the
abutment teeth and not to the gums underneath. Therefore, teeth perform the
mastication, which is the natural way.
• By contrast, removable dentures rest exclusively on the gums; therefore, the
chewing process (or at least part of it) is performed on the gums.

19. advantages of dental bridges
4. Aesthetics are very good
• When aesthetic demands are high, it is advisable to opt for porcelain or
zirconium-based bridges, which are aesthetically superior.
5. Few appointments are needed
• Bridges can be completed in two sessions, while removable dentures need at
least 4 appointments to be completed. Dental implants need 3 to 6 months after
the surgical insertion to fuse with the bone through a biologic process called
osseointegration.
6. Lifespan and prognosis are good
• To ensure this goal, dental bridges need to be properly maintained.

20. When is a dental bridge NOT indicated?
1. Restoring toothless gaps when there is not enough support
If the number of abutment teeth is not enough to support the bridge or some teeth are
unsuitable (show large destructions, are too loose etc.), it is advisable to opt for a different
type of prosthetic reconstruction: removable dentures or implant-supported restorations.
...more about abutment teeth selection
2. Poor oral hygiene
It is not advisable to design a dental restoration (particularly a large one) if the patient
does not have a proper oral hygiene. The most sophisticated and expensive restorations
will have a very short lifespan in the absence of an accurate and thorough oral hygiene.
3. General conditions
Some serious general conditions can make anesthesia and dental procedures inadvisable.
Generally, these situations will be evaluated on a case-by-case basis and the treatment will
usually resume after some preliminary treatments.

21. Dental bridges drawbacks
Bridges require the preparation of the abutment teeth
• To ensure the bridge support and insertion, the abutment teeth need
to be properly prepared. This operation involves permanently
removing part of the tooth's original structure, including portions that
might still be healthy and structurally sound.
• It's the biggest disadvantage as it leads to the loss of large amounts of
healthy tooth tissue and sometimes even tooth devitalization and
endodontic treatment. Therefore, restorations supported exclusively
by dental implants have the big advantage that teeth adjacent to the
gap remain untouched.

22. Dental bridges drawbacks
• This disadvantage stands out especially when the abutment teeth are perfectly healthy without
any fillings or cavities.
• The abutment teeth may show increased sensitivity to external stimuli
• Usually, after teeth preparation, one or more temporary crowns are constructed. These devices
will protect the abutment teeth until the definitive restoration is completed.
• If no temporary restoration was designed, abutment teeth may show an increased sensitivity to
hot or cold stimuli until the bridge is definitively cemented.

23. Thank you!