Partials, Dentures and Bridges

Partials and Denture Information
Some patients have not been fortunate enough to save their teeth and thereby require dental appliances that will restore function and esthetics. We take special care in making these appliances to ensure proper fit and comfort. We record initial measurements of jaw position and make accurate impressions of the upper and lower ridge forms.

There are several visits to allow the patient to try-in the appliance and also to get an idea of the end result prior to delivering the denture to ensure patient satisfaction. Follow up appointments are made during the adjustment phase to obtain the most comfortable fit.

Fixed Partials, Dentures and Bridges
Diagnosis is the basis of a rational treatment plan and successful dental care is only possible with effective planning. Diagnosis involves collecting facts from the patient through an extensive patient interview, thorough clinical oral exam, making diagnostic casts and evaluation of radiographs. When planning treatment for the entire patient the desires of the patient should take priority however the dentist should not deliver substandard care claiming the patient wanted specific treatment. Communication is therefore key to meet a patient’s expectations and to provide the best results feasible.

In patients that are missing teeth many options are available for replacing these teeth: however, evaluation of the remaining dentition is very crucial for effective dental treatment. It is the supporting teeth that will dictate whether or not a fixed/cemented prosthesis can be fabricated. Bridges replace one or more missing teeth and are attached definitively to the remaining teeth. The teeth that support the bridge are called abutments/crowns and the missing teeth are known as pontics. The abutment teeth need to be of adequate periodontal health, proper angulations and healthy to withstand masticatory forces.

Root canal treated teeth need to have sufficient supragingival tooth structure to retain a crown and be free of any pathosis. It is the evaluation of these abutment teeth that will determine the success of a fixed bridge. The procedure for a fixed bridge is as follows. The initial dental visit consists of preparing the abutment teeth. The teeth determined to serve as abutments are shaped and reduced to make room for the abutment crowns. An impression of these teeth is then made and sent to the laboratory for the fabrication of the underlying metal substructure of the bridge.

During this visit a temporary is made chair side that will cover and protect these abutment teeth and the missing teeth are also added to this temporary, thereby creating a resin temporary bridge. The second visit entails taking a shade for color matching the existing teeth, trying in the metal substructure to ensure perfect fit and then making a secondary impression is made to register the patient’s bite.

This impression is sent to the lab to fabricate the bridge through the addition of porcelain to the metal framework. The porcelain teeth are fabricated to match the existing teeth in both color and shape, or they may be fabricated in such a way as to correct any malformations or malpositioning of teeth. At the third visit the final bridge is tried in, final occlusal/bite adjustments made, then cemented into the patient’s mouth. Fixed bridges do require extra maintenance, since flossing is more difficult between the abutment and the pontic teeth; therefore routine dental care is crucial in ensuring the lifespan of bridges.

FAQ’s About Dentures, Partials and Bridges:

Are bridges harder to maintain than natural teeth or implant teeth?
Yes bridges are more difficult to maintain because flossing is more difficult for the patient. Special dental floss devices will be given to the patient for proper maintenance of bridges.

Are implants better than bridges?
In most cases implants are better restorations than bridges because implants are easier to maintain than bridges: however, not all patients are good candidates to receive implants. Sometimes due to a patients oral anatomy implant placement is not advisable. In turn bridges may also not be advisable to some patients due to the condition of the adjacent teeth. A thorough evaluation is necessary before recommending either of these options.

How soon after an extraction should a bridge be made?
Approximately 4-6 weeks following an extraction a bridge should be fabricated in order to prevent any shifting of the adjacent teeth. It also takes about that amount of time for an extraction socket to heal adequately; however, a temporary bridge can be started immediately after the extraction to replace the missing tooth. The final bridge should be cemented in about 4-6 weeks.

How long do bridges last?
If maintained properly bridges last about 5-10 years and sometimes longer.